roneuro - escnp · adriana sarah nica /romania gelu onose /romania ioan onac /romania cristian...

5TH EUROPEAN TEACHING COURSE on NEUROREHABILITATION

14TH CONGRESS OF EUROPEAN SOCIETY for CLINICAL NEUROPHARMACOLOGY

RoNeuro BRAIN DAYS

JUNE 1-4, 2015 | CLUJ-NAPOCA | ROMANIA

FOUNDATION OF THESOCIETY FOR THE STUDY OFNEUROPROTECTION AND

NEUROPLASTICITY

FOUNDATION

OF TH

E SOC

IETY FOR THE STUDY OF NEUROPR

OTE

CTI

ON

AN

D N

EU

ROPLASTICITY •

Institute for Neurological Research and Diagnostic

www.roneuro.ro | www.ssnn.ro

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VOLKER HÖMBERG

Program Chairman

EFNRS Secretary General

WFNR Secretary General

HEINRICH BINDER

Program Co-Chairman

EFNRS Past President

DAFIN F. MUREȘANU

Course Director

President of the Romanian

Society of Neurology

SSNN President

WELCOME ADDRESS

This event is organized by the Foundation of the Society for the Study of Neuroprotection and Neuroplasticity, together with the Romanian Society of Neurology and “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania, and is endorsed, as the previous ones, by the World Federation of Neurorehabilitation (WFNR) and European Federation of Neurorehabilitation Societies (EFNRS).

After three successful past events, the meeting in Cluj will again present a platform for exchange of newest scientific information as well as providing space for teaching oriented workshops. We try to reach an audience of all colleagues with an interest in this steadily expanding and exciting field (physicians, nurses, therapists, basic scientists etc.)

A major topic will be to come to a resume where neurorehabilitation in Europe stands today and where future perspectives in science and education as well as in optimizing services shall go. The formats used in the meeting as well as the selected main thematic areas will certainly have a chance to be of interest to a wide audience.

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SCIENTIFIC COMMITTEE & FACULTY

LOCAL COMMITTEE

Silviu Albu /RomaniaMihaela Baciut /RomaniaOvidiu Bajenaru /RomaniaLeontino Battistin /ItalyHeinrich Binder /AustriaDana Boering /GermanyAngelo Bulboaca /RomaniaAnca D. Buzoianu /RomaniaVitalie Chiosa /Republic of MoldovaMichael Chopp /USALacramioara Perju Dumbrava /RomaniaDaniela Efremova /Republic of MoldovaAlexandru Gasnas /Republic of MoldovaMihail Gavriliuc /Republic of MoldovaVolodymyr Golyk /UkarineStanislav Groppa /Republic of MoldovaWolf Dieter Heiss /AustriaDirk M. Hermann /GermanyVolker Hömberg /GermanyPeter Jenner /UKAmos D. Korczyn /IsraelVitalie Lisnic /Republic of MoldovaAlbert Ludolph /GermanyTudor Lupescu /RomaniaIon Moldovanu /Republic of MoldovaDafin F. Mureşanu /RomaniaAdriana Sarah Nica /RomaniaGelu Onose /RomaniaIoan Onac /RomaniaCristian Falup-Pecurariu /RomaniaC. D. Popescu / RomaniaPeter Riederer /GermanyMarina Sangheli /Republic of MoldovaStephen Skaper /ItalyJohannes Thome /GermanyIoan Veresiu / RomaniaJohannes Vester /GermanyAurel Popa-Wagner /GermanyAndreas Zwergal /Germany

Mihaela Baciut /RomaniaGrigore Baciut /RomaniaMaria Balea /RomaniaAngelo Bulboaca /RomaniaAnca Buzoianu /RomaniaNicu Draghici /RomaniaLacramioara Perju Dumbrava /RomaniaŞtefan Florian /RomaniaIuliana Gainariu /RomaniaIoan Marginean /RomaniaAlina Nagy /RomaniaIoan Onac /RomaniaLivia Popa /RomaniaOvidiu Selejan /RomaniaAdina Stan /RomaniaDana Slavoaca /Romania

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ORGANIZERS

FOUNDATION OF THESOCIETY FOR THE STUDY OFNEUROPROTECTION AND

NEUROPLASTICITY

FOUNDATION

OF TH

E SOC

IETY FOR THE STUDY OF NEUROPR

OTE

CTI

ON

AN

D N

EU

ROPLASTICITY •

Institute for Neurological Research and Diagnostic

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MEDIA PARTNERS

C L U J

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GENERAL INFORMATION

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COURSE VENUE

“IULIU HATIEGANU” Auditorium,23 Gheorghe Marinescu StreetCluj Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy

Scientific Secretariat

Foundation of theSociety for the Study of Neuroprotection and Neuroplasticity37 Mircea Eliade Street, 400364, Cluj-Napoca, RomaniaOffice phone: +40745255311E-mail:[email protected]

Contact Details

Mrs. Doria Constantinescu, mobile: [email protected]

Mrs. Diana Biris, mobile: [email protected]

Registration Desk

All materials and documentation will be available at the registration desk located at SSNN booth.The staff will be pleased to help you with all enquiries regarding registration, materials and program. Please do not hesitate to contact the staff members if there is something they can do to make your stay more enjoyable.

GENERAL INFORMATION

LOGISTIC PARTNER:

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LANGUAGE

The official language is English. Simultaneous translation will not be provided.

CHANGES IN PROGRAM

The organizers cannot assume liability for any changes in the program due to external or unforeseen circumstances.

NAME BADGES

Participants are kindly requested to wear their name badge at all times. The badge enables admission to the scientific sessions and dinners.

FINAL PROGRAM & ABSTRACT BOOK

The participants documents include the program and abstract book which will be handed out at the registration counter.

COFFEE BREAKS

Coffee, tea and water are served during morning coffee breaks and are free of charge to all registered participants.

MOBILE PHONES

Participants are kindly requested to keep their mobile phones turned off while attending the scientific sessions in the meeting rooms.

CURRENCY

The official currency in Romania is RON.

ELECTRICITY

Electrical power is 220 volts, 50 Hz.Two-prong plugs are standard.

TIME

The time in Romania isEastern European Time (GMT+2).

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SCIENTIFIC PROGRAM

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MONDAY, JUNE 1ST, 201508:50 – 09:00 Welcome address WFNR and EFNRS activities update Volker Homberg (Germany)

European curriculum for residency training in neurorehabilitation Volker Homberg (Germany)

PRESIDENTIAL SESSION ___________________________________________Chairpersons: Dafin Muresanu (Romania), Volker Homberg (Germany)

09:00 – 09:35 Sense and nonsense of using ICF in neurorehabilitation Volker Homberg (Germany)

09:35 – 10:10 International Brain Research Organization (IBRO) Special lecture Promoting neurological recovery and brain plasticity in the ischemic brain: opportunities and challenges Dirk M. Hermann (Germany)

10:10 – 10:45 Advances in neurorehabilitation fundamentals - an update Dafin Muresanu (Romania)

10:45 – 10:55 Discussions

10:55 – 11:20 COFFEE BREAK

5TH EUROPEAN TEACHING COURSE on NEUROREHABILITATION


RoNeuro BRAIN DAYS

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SESSION 1 ___________________________________________Chairpersons: Dirk M. Hermann (Germany), Andreas Zwergal (Germany)

11:20 – 11:50 The diabetic brain-neurovascular and cognitive dysfunction, and stroke in the diabetic brain-potential neurorestorative therapeutic approaches Michael Chopp (USA)

11:50 – 12:20 Exosomes and microRNAs in mediating neurorestoration after stroke and neural injury Michael Chopp (USA)

12:20 – 12:50 Co-ultramicronized palmitoylethanolamide/luteolin promotes maturation of rat cortical oligodendrocytes Stephen Skaper (Italy)

12:50 – 13:00 Discussions 13:00 – 14:00 LUNCH

SESSION 2 ___________________________________________Chairpersons: Michael Chopp (USA), Albert Ludolph (Germany)

14:00 – 14:30 Neurootology update Andreas Zwergal (Germany)

14:30 – 15:00 Motor rehabilitation: training techniques derived from motor learning knowledge Volker Homberg (Germany)

15:00 – 15:30 Motor rehabilitation: physical therapy Volker Homberg (Germany)

15:30 – 16:00 Robots in neurorehabilitation. Sense and nonsense Volker Homberg (Germany)



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SESSION 3 ___________________________________________Chairpersons: Heinrich Binder (Austria), Stephen Skaper (Italy)

16:40 – 17:10 ALS genotypes and phenotypes Albert Ludolph (Germany)

17:10 – 17:40 The forgotten autonomous system in early rehabilitation Heinrich Binder (Austria)

17:40 – 18:10 What’s the meaning of early rehabilitation in neurodegenerative diseases? Heinrich Binder (Austria)


TUESDAY, JUNE 2ND, 2015

SESSION 4 ___________________________________________Chairpersons: Ovidiu Bajenaru (Romania), Amos Korczyn (Israel)

08:30 – 09:00 Management of dysphagia after stroke Dana Boering (Germany)

09:00 – 09:30 Pressure ulcer prevention and management during the early phase after stroke Dana Boering (Germany)

09:30 – 10:00 Non-invasive brain stimulation in rehabilitation after stroke Wolf Dieter Heiss (Germany)



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SESSION 5 ___________________________________________Chairpersons: Wolf Dieter Heiss (Germany), Peter Jenner (UK)

10:40 – 11:10 Neurorehabilitation strategy in patients with focal dystonia Ovidiu Bajenaru (Romania)

11:10– 11:40 Vascular Parkinsonism Amos Korczyn (Israel)

11:40 – 12:10 Pain and sleep disturbances in Parkinson’s disease Cristian Falup Pecurariu (Romania)


12:20 – 13:20 LUNCH

SESSION 6 ___________________________________________Chairpersons: Ioan Marginean (Romania), Johannes Vester (Germany)

13:20 – 13:50 Novel pharmacological approaches to the treatment of Parkinson’s disease Peter Jenner (UK)

13:50 – 14:20 Continuous drug delivery in early- and late-stage Parkinson’s disease. Peter Jenner (UK)

14:20 – 14:50 Levodopa—carbidopa intestinal gel and brainstem auditory evoked potentials in advanced Parkinson’s disease C.D. Popescu (Romania)



SESSION 7 ___________________________________________Chairpersons: C.D. Popescu (Romania), Volodymyr Golyk (Ukraine)

15:30 – 16:00 Medically unexplained symptoms in neurology Amos Korczyn (Israel)

16:00 – 16:30 Principles of neurorehabilitation in vestibular system disorders Volodymyr Golyk (Ukraine)

16:30 – 17:00 Is there a chance for clinical research in neurorehabilitation within the framework of evidenced-based medicine? Classic and new approaches Johannes Vester (Germany)


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WEDNESDAY, JUNE 3RD, 2015

SESSION 8 ___________________________________________Chairpersons: Gelu Onose (Romania), Adriana Sarah Nica (Romania)

08:30 – 09:00 Propaedeutics for rehabilitation in the central nervous system traumatology (postacute/ subchronic stages) Gelu Onose (Romania)

09:00 – 09:30 Nutritional care of neurological disabled patients Adriana Sarah Nica (Romania)

09:30 – 10:00 Combination of granulocyte colony-stimulating factor with and BM MSC and BM MNCs for stroke treatment in aged rats is not superior to G-CSF alone Aurel Popa Wagner (Germany)



SESSION 9 ___________________________________________Chairpersons: Aurel Popa Wagner (Germany), Vitalie Lisnic (Rep. Moldova)

10:40 – 11:10 Results from a large retrospective cohort trial in TBI Dafin Muresanu (Romania)

11:10 – 11:40 The benefit of high-end neurological therapy in maxillofacial surgery Mihaela Baciut (Romania)


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SESSION 10 ___________________________________________Chairpersons: Tudor Lupescu (Romania), Ioan Veresiu (Romania)

11:50 – 12:20 Symptomatic treatment in diabetic neuropathy Tudor Lupescu (Romania)

12:20 – 12:50 Impairment of the central nervous system in demyelinating polyneuropathies: neurophysiological, clinical and neuroimaging aspects Vitalie Lisnic (Rep. Moldova) 12:50 – 13:20 Are there evidences for pathogenesis-based approach of diabetic neuropathy? Ioan Veresiu (Romania)


13:30 – 14:30 LUNCH


14:30 – 14:40 Welcome address

SECTION 1 ___________________________________________Chairpersons: Peter Riederer (Germany), Leontino Battistin (Italy)

14:40 – 15:10 Brain cholesterol: implications in the treatment of neurological diseases Ovidiu Bajenaru (Romania)

15:10 – 15:40 Pharmacological support in traumatic brain and spinal cord injury Dafin Muresanu (Romania)

15:40 – 16:10 Disease course modification in Parkinson’s disease Amos Korczyn (Israel)



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SECTION 2 ___________________________________________Chairpersons: Anca Buzoianu (Romania), Cristian Falup Pecurariu (Romania)

16:50 – 17:20 Virus and Parkinsonism Peter Riederer (Germany)

17:20 – 17:50 Therapeutic approaches to non-motor Parkinson’s disease Leontino Battistin (Italy)

17:50 – 18:20 New aspects on glatiramer acetate mechanism of action in MS Anca Buzoianu (Romania)

18:20 – 18:50 Using CLOCK-gene related mechanisms in the treatment of neuropsychiatric disorders Johannes Thome (Germany)


THURSDAY, JUNE 4TH, 2015

SESSION 11 ___________________________________________Chairpersons: Dafin Muresanu (Romania), Stanislav Groppa (Rep. Moldova)

08:30 – 09:00 The role of neurotrophic factors in brain protection and recovery after stroke Dafin Muresanu (Romania)

09:00 – 09:30 Features of clinical polymorphism and etiology of seizures Stanislav Groppa (Rep. Moldova)

09:30 – 10:00 The importance of high-density EEG in the detection of epileptiforminterictal changes and location of the epileptogenic foci Vitalie Chiosa (Rep. Moldova)



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SESSION 12 ___________________________________________Chairpersons: Lacramioara Perju Dumbrava (Romania), Angelo Bulboaca (Romania)

10:40 – 11:10 Atypical forms of chronic inflammatory demyelinating polyneuropathy Vitalie Lisnic (Rep. Moldova)

11:10 – 11:40 Visual symptoms as nonmotor phenomena in Parkinson’s disease Lacramioara Perju Dumbrava (Romania)

11:40 – 12:10 Motor control and eye-hand coordination in neurorehabilitation Angelo Bulboaca (Romania)

12:10 – 12:40 Clinical and therapeutic aspects in lumbar sciatica by disc herniation Ioan Onac (Romania)


12:50 – 13:50 LUNCH

SESSION 13 ___________________________________________Chairpersons: Ion Moldovanu (Rep. Moldova), Marina Sangheli (Rep. Moldova)

13:50 – 14:20 Phenomena of pre- and postischemic conditioning: theoretical, experimental and clinical aspects Mihail Gavrilciuc (Rep. Moldova)

14:20 – 14:50 Risk factors and secondary prevention of ischemic stroke in the population of Moldova Daniela Efremova (Rep. Moldova)

14:50 – 15:20 Importance of motor and pharmacological interventions in stroke rehabilitation C.D. Popescu (Romania)

15:20 – 15:50 Transcranial Magnetic Stimulation (TMS) and results of connectivity studies in acute ischemic stroke Alexandru Gasnas (Rep. Moldova)



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SESSION 14 ___________________________________________Chairpersons: Mihail Gavrilciuc (Rep. Moldova), Alexandru Gasnas (Rep. Moldova)

16:30 – 17:00 Chronic migraine associated with autonomic disorders and other related comorbidities Ion Moldovanu (Rep. Moldova)

17:00 – 17:30 Consciousness, altered states of consciousnessand brain plasticity: therapeutical perspectives Ion Moldovanu (Rep. Moldova)

17:30 – 18:00 Epidemiological study of multiple sclerosis in the Republic Of Moldova Marina Sangheli (Rep. Moldova)


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ABSTRACTS

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MIHAELA BACIUT

Grigore Baciut, Dafin Muresanu*, Simion Bran, Andreea Magdas

Department of Maxillofacial Surgery and Oral Implantology,

*Department of Neurosciences“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

THE BENEFIT OF HIGH-END NEUROLOGICAL THERAPY IN MAXILLOFACIAL SURGERY

Surgical procedures performed in maxillofacial surgery imply dissection in the immediate vicinity of sensitive (trigeminal nerve) and motor (facial nerve) trunks or branches frequently. The nerve function can suffer postoperatively, with severe consequences altering the life quality of the patient.

In order to quantify the dysfunction, two major fields of maxillofacial surgery, parotid tumor surgery and orthognathic surgery were analyzed. With the increasing number of parotid gland tumors, this surgery has become a daily routine in our center. Various branches of the facial nerve crossing the implied region can be involved in the tumor and require surgical dissection or extirpation. Orthognathic surgery, on the other hand, is performed increasingly for correction of maxillofacial deformities. It implies osteotomies of the maxillary bones to correct their position and/or dimension in cases of maxillofacial deformities. The branches of the trigeminal nerve can suffer from intraoperative trauma or in the postoperative period.

During the healing period, progressive clinical improvement of the motoric dysfunctional region and anesthetized region respectively is observed.

High-end neurological therapy modalities are evaluated in this study pertaining to their regenerative neurological capacity in patients having undergone maxillofacial surgery procedures.

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BRAIN CHOLESTEROL: IMPLICATIONS IN THE TREATMENT

OF NEUROLOGICAL DISEASES

Cholesterol is one of the most important structural chemical components of the CNS; aproximatively 25% of the whole quantity of cholesterol in the human body is to be found only in the CNS. The structural importance of cholesterol in the CNS is related mainly to its major role in the normal function of the membranes, both cell membranes and organelles’ membranes ( particularly in neurons ). The biological importance of the lipid rafts containing cholesterol in membranes for the normal neuronal and synaptic functions, could be also suggested by the fact that the CNS cholesterol is not produced in the liver as for the rest of the tissues in the body, but inside the CNS itself, in particular by astrocytes which have the whole enzymatic and proteic equipment for its synthesis, metabolism and intercellular trafficking; more than this, the BBB does not allow the passage of systemic cholesterol from the blood to the brain, but allows the transfer of some of cholesterol derivatives from the CNS tissue to the blood, influencing the cholesterol homeostasis in the brain. The careful understanding of the cholesterol role and metabolism in the CNS has been related to different neuropathological conditions such as Alzheimer’s disease, vascular cognitive impairment, depression and also to some therapeutic particularities of statins not only for cerebro-vascular disorders, but also for demential diseases and multiple sclerosis.

NEUROREHABILITATION STRATEGY IN PATIENTS WITH FOCAL DYSTONIA

Primary dystonia is a complex pathophysiological condition which essentialy is determined by synaptic abnormalities in the motor basal ganglia circuits connecting these structures with the cortical areas related to motor control on one hand, and on the other hand inducing a dysbalance in the supraspinal dyscharges on the peripheral motor perycaria in the spinal cord and brainstem, which clinically manifest as chronic dystonic movements. More than these, at the muscle level, abnormalities in the function of the neuromuscular spindles are also present, and these abnormalities are enhanced by their chronic overstimulation due to dystonia itself, which in turn determine abnormal proprioceptive informations to the motor cortex. As a consequence, the cortical representation of the dystonic muscles extends on the motor cortical maps due to a maladaptive neuroplasticity, which final consequence is the presence of a vicious circle manifesting as an overactivity in those motor circuits, perpetuating and enhancing dystonia. The usual treatment of these disorders consists in periodic local injections of botulinum toxin or in some cases stereotactically guided DBS in the basal ganglia ( usually in GPi ), but these have to be just one component of the treatment of these motor disorders, which have to be completed in a complementary manner by a complex functional rehabilitation by kinesitherapy. Kinesitherapy procedures have to take into account all these pathogenetic mechanisms, in order to facilitate the cortical motor map reorganization to normal parameters and in the same time to evitate the peripheral stimulation and overactivity in the muscle spindles local discharges to the CNS, with the aim to bring to normal as much as possible the spinal and cortical afferent proprioceptive information.

OVIDIU BAJENARU

University of Medicineand Pharmacy“Carol Davila”,Bucharest,Romania

Director of theDepartment ofNeurology,Neurosurgery andPsychiatry

Chairman and Headof Dept. Neurology -University EmergencyHospital, Bucharest,Romania

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LEONTINO BATTISTINAngelo Antonini

Department of Neurosciences, Medical School, University of Padua, Italy

Neurorehabilitation Scientific Hospital, IRCSS San Camillo, Venice, Italy

THERAPEUTIC APPROACHES TO NON-MOTOR PARKINSON’S DISEASE

In recent years it has become increasingly evident that in Parkinson disease together with the classic motor disability patients complain about a number of non-motor symptoms (NMS) . While knowledge of NMS associated with PD is not new – James Parkinson described such symptoms almost 200 years ago – it is the increasing recognition of their diversity, prevalence and impact on patients’ health-related quality of life that has led to a significant shift in diagnostic and therapeutic approaches to the disease.

Almost all patients with PD suffer from NMS. NMS have a greater detrimental impact on health related quality of life than motor symptoms and are frequently under-reported by patients and under-recognised by physicians. Furthermore, little is known about their progression, their response to dopaminergic medication and their occurrence in the context of nonmotor fluctuations. The development of instruments for screening and evaluation of NMS represents an important step forward in the recognition of these disturbances, but they do not clearly establish the relationship with disease and the response to treatment. The response of individual NMS to dopaminergic treatment depends on the mechanism underlying its development. Indeed NMS may originate from multiple causative processes, underpinned by predominant involvement of non-dopaminergic circuits or even secondary to medications. Moreover concomitant conditions could produce clinical features mimicking PD-related NMS, which will likely be refractory to dopaminergic treatment.

Available evidence shows that dopamine agonists can improve specific NMS. The most recent results regard rotigotine , a non-ergoline dopamine receptor agonist administered transdermally via a patch which demonstrated significant improvements in early morning motor impairment and nocturnal sleep disturbances a double-blind, placebo-controlled trial. Pramipexole was also tested and demonstrated to be beneficial in PD patients complaining about depression and apathy.

Finally, non-dopaminergic therapies however, remain the key therapeutic options for many NMS such as excessive daytime sleepiness, constipation, dribbling of saliva, insomnia and REM behavior disorders.

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HEINRICHBINDER

LandsteinerInstitute forNeurorehabilitationand Space Medicine

Vienna, Austria

THE FORGOTTEN AUTONOMOUS SYSTEM IN EARLY REHABILITATION

In early rehabilitation relevancy of respiration, cardiovascular circulation and excretory functions as voiding and defaecation are neglected for the most part from neurological side. There is nearly no acute occurring neurological disease without respiratory disturbances. Therefore mechanical ventilation, tracheostomy, weaning and various complications are common. Cardiovascular disturbances appear on the one side as consequence of nervous lesions at various levels brain or spinal cord. On the other side suffer 75% of stroke patients from a cardiac disease and one might argue that stroke patients very often are far more disabled by their cardiac condition than by the stroke itself. Not least inability to control voiding and defaecation pose a common problem. Knowledge of pathophysiology, treatment and rehabilitation challenges regarding this is mostly disregarded in neurorehabilitative education and therefore delegated.

WHAT’S THE MEANING OF EARLY REHABILITATION IN NEURODEGENERATIVE DISEASES?

When does rehabilitation actually start? According to a type of chronological order, curative medicine comes before rehabilitation. Rehabilitation is oriented according to the biomedical model, which is exclusively aimed at the restoration of organ damage and/or organ dysfunction. From the ontological point of view, organ damage and/or organ dysfunction are the results of the course of an illness. According to this process of illness, one has to regard three main points in early rehabilitation.

First, neurological diseases are mostly chronically progressing illnesses that have started subclinically long before the first symptoms and discomfort are experienced. This concerns particularly the so-called neurodegenerative diseases. These mostly develop slowly so that one really cannot ascertain their very beginning.

Second, instead of improvement because of curative medicine, the illnesses are grossly progressive. Therefore, they lead to an increase in symptoms or development of new complaints.

Third, besides the nervous system, there is usually one or more organ systems affected. This leads, finally, to a competition of causalities and interactions.

Early diagnosis is mandatory. To make a prognosis and to estimate expected impairments is the next step. It is important to distinguish between first-order impairments attributable to the differently afflicted nervous system and their negative effects on different other organs. The neurorehabilitation task is support of adaptive reconfiguration in the former and prevention in the latter case.

Binder H.: Neurorehabilitative interventions in the acute stage of diseases. Textbook of Neural Repair and Rehabilitation 2e, eds. Michael E. Selzer, Stephanie Clarke, Leonardo G. Cohen, Gert Kwakkel, and Robert H.

Miller. Published by Cambridge University Press. © Cambridge University Press 2014

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Dysphagia affects more than 50% of stroke survivors and represents one of the first hurdles on the path of recovery after stroke, leading to a 17% increase of pulmonary infections and a 30% increase of mortality. Prompt evaluation and treatment of swallowing disorders can therefore mitigate the development of further secondary complications and foster social reintegration of stroke patients.

The talk will give an overview of swallowing physiology and neural control, of bedside screening tests, of clinical and instrumental assessment methods, a brief insight in the mechanisms of postlesional plasticity in poststroke dysphagia and in the nutritional assessment and support of the patients. It will give a detailed presentation of the different compensatory and rehabilitative techniques pointing out new trends in dysphagia management and possible future developments of this rapidly evolving field.

PRESSURE ULCER PREVENTION AND MANAGEMENT DURING THE EARLY PHASE AFTER STROKE

Pressure ulcers are painful, costly and often preventable complications during the early phase after stroke. Their prevention and timely management is of great importance, knowing that hospital lengths of stay, readmission rates, motor gains and average hospital costs are greater in patients who develop pressure ulcer than in those who don´t and that the Admission Norton Scale scores not only predict pressure ulcer development, but also mortality a year after rehabilitation.

The talk will give an overview concerning NPUAP classification, pathophysiology, risk assessment for pressure ulcer, including nutritional risk, skin assessment, preventive strategies about nutrient intake management, skin care, repositioning, support surfaces and prophylactic dressings. Further it will deepen aspects of pressure ulcer treatment beginning with validated monitoring tools, special nutritional aspects, support surfaces, cleansing, debridement, infection management, negative pressure wound therapy and pain management.

MANAGEMENT OF DYSPHAGIA AFTER STROKE

DANABOERING

St. Mauritius Therapieklinik

Meerbusch, Germany

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ANCA D. BUZOIANU

Vitalie Vacaras, Major Zoltan, Dafin F. Muresanu

Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

NEW ASPECTS ON GLATIRAMER ACETATE MECHANISM OF ACTION IN MS

Multiple sclerosis (MS) is a major health issue among young individuals, since it is a debilitating disease which interrupts the most prolific period in a human’s life. Glatiramer acetate (GA) is one of the most widely used disease-modifying drugs for the treatment of relapsing-remitting multiple sclerosis, with increasingly promising long term outcome, as follow-up studies are being carried out.However, there are still many aspects not completely clarified regarding the mechanism of action of this molecule.

As for a mechanism, it was widely thought that GA has an inductor effect on neurotrophic factor expression. One of these neurotrophic factor systems is the brain-derived neurotrophic factor (BDNF)/receptor tyrosine kinase B (TrkB) pathway. Peripheral blood is thought to contain soluble BDNF, and some blood cells express TrkB.

Our research was oriented towards outlining whether GA treatment leads to changes in plasma BDNF levels and TrkB activation. We’ve hypothesized that such a phenomenon might occur in relapsing-remitting multiple sclerosis patients treated with the drug.

Results showed the opposite: GA treatment, after one year of sustained therapy, is not influencing peripheral BDNF levels, not from the point of view of total free BDNF nor the phosphorylated TrkB. In spite of this, results also mirror that even if the present treatment is not producing any quantifiable effect on the BDNF/TrkB system, a considerable difference between the activity of the couple is seen when MS is compared with healthy controls, the expression being significantly reduced.

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High-density EEG is a method of electroencephalography recorded by 256 scalp electrodes, evenly covering the whole surface of the head, contributing to more accurate view of electrical source due to higher spatial and temporal resolution. The high spatial resolution combined with magnetic resonance characteristics of brain can provide the accurate information of epileptiform changes on EEG and localization of epileptogenic foci (ESI - Electrical Source Imaging). Several studies have demonstrated the clinical utility of the high-density EEG and ESI in the pre-surgical clinical evaluation of pharmacoresistant epilepsy. Locating spike sites using high-density EEG has proven to be more effective in predicting the seizure onset zone than other methods, including PET, MRI and ictal SPECT.

Keywords: High-density EEG, pharmacoresistant epilepsy, nonlesional epilepsy, Magnetic Resonance Imaging, Electrical Source Imaging.

THE IMPORTANCE OF HIGH-DENSITY EEG IN THE DETECTION OF EPILEPTIFORM INTERICTAL CHANGES AND

LOCATION OF THE EPILEPTOGENIC FOCI

VITALIE CHIOSA

Groppa St. Gorincioi N. Ciolac D. Misina L. Munteanu C. Vataman A.

“Nicolae Testemitanu” State University of Medicine and Pharmacy Chisinau, Republic of Moldova

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LACRAMIOARA PERJU-DUMBRAVA

University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Romania

VISUAL SYMPTOMS AS NONMOTOR PHENOMENA IN PARKINSON’S DISEASE

Along with the motor symptoms, Parkinson’s disease (PD) patients experience a wide range of non-motor problems including visual disturbances. These are multifaceted, but often under-reported as such. In a visual survey questionnaire, 78% PD patients reported at least one problem related to vision or visuospatial functioning

The most frequent encountered problems are impaired contrast sensitivity, color discrimination, visuospatial processing, ocular or eyelid movements and diplopia followed by visual misperceptions and hallucinations. Some patients report dry eyes, ocular pain or photophobia.

The pathophysiological basis of the visual disturbances is not completely understood. Changes in the visual cortex were detected with functional MRI before the visual symptoms were clinically evident. Further studies are necessary to determine how these changes will contribute to development of visual symptoms in PD patients. The possible role of retinal dopaminergic system is also considered to be responsible for some of these symptoms, being known that dopamine is the major neurotransmitter in the amacrine and interplexiform cells in the retina. Visual hallucinations are likely to be a result of disruption across related yet diverse neural circuitry.

The therapy is only symptomatic and not always satisfactory. It includes ophthalmological treatment, botulinum toxin for blepharospasm and specific treatment for hallucinations. This work shows how complex the visual problems in PD patients can be and the importance of a thorough and multidisciplinary approach.

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MICHAEL CHOPP1,2

1. Henry Ford Hospital, Department of Neurology, Detroit, MI, USA

2. Oakland University, Department of Physics,

Rochester, MI, USA

THE DIABETIC BRAIN-NEUROVASCULAR AND COGNITIVE DYSFUNCTION, AND STROKE IN THE

DIABETIC BRAIN-POTENTIAL NEURORESTORATIVE THERAPEUTIC APPROACHES

Diabetes, particularly in the elderly contributes to cognitive and learning deficits. In addition, diabetes is a major risk factor for stroke, and approximately one-third of all stroke patients are diabetic. Here, I will describe our work on the neurovascular dysfunction in the diabetic brain, first without stroke and then after stroke. Type 2 diabetes (T2DM) in the older rat will be shown to induce neurovascular dysfunction and significant cognitive loss compared with the non-diabetic aged–matched brain. The diabetic brain exhibits increased loss of axons and oligodendrocytes, reduced myelination and reduced spine density, as well as substantial fibrin deposition compared with the non-diabetic aged-matched brain. In addition, the T2DM aging brain exhibits an impaired glymphatic system. Non-invasive MRI evaluation of the glymphatic system, providing an index of interstitial solute clearance, demonstrates that glymphatic impairment is highly correlated with cognitive loss. Stroke in the T2DM brain greatly exacerbates neurovascular dysfunction and impaired neurological sequelae in the diabetic brain compared with the non-diabetic brain. The diabetic brain post stroke exhibits increased inflammation and axonal damage. Molecular mechanisms underlying the exacerbation of neurological deficits and impaired neurovascular function after stroke in the T2DM animal will be described, including the adverse effects of substantially reduced angiopoietin 1 as well as microRNA-126, an important non-coding RNA which plays a vital role in orchestrating neurovascular health. Restorative therapies, such as delayed treatment of stroke in the diabetic animal with human umbilical cord blood cells which enhance angiopoietin and miR-126, will be described.

EXOSOMES AND MICRORNAS IN MEDIATING NEURORESTORATION AFTER STROKE AND NEURAL INJURY

My lecture will primarily focus on the development of neurorestorative therapies for stroke and traumatic brain injury (TBI). Historically, therapeutic approaches to stroke have targeted neuroprotection, i.e. reduction of the ischemic lesion. However, acutely applied neuroprotective agents for stroke have failed in clinical trials, and thrombolysis with tPA is employed in fewer than 10% of all patients with ischemic stroke. In contrast, neurorestorative strategies, designed to enhance neurovascular remodeling of intact tissue, may be applied during the subacute and chronic phases post stroke. Neurorestorative therapies are not hampered by a narrow therapeutic window, a race against cell death, and potential adverse reactions associated with thrombolysis, and therefore may be employed in all stroke patients. Post stroke and TBI, there is evidence of neurovascular remodeling, which leads to modest and most often inadequate recovery. However, with increased efforts to elucidate the biological substrates underlying and driving plasticity in the CNS, we are able to amplify endogenous neurorestorative processes and thereby enhance neurological recovery. In this lecture, molecular and cellular neurorestorative therapeutic approaches will be outlined, and novel neurorestorative directions including the use of non-coding RNAs and nanomedicine as a means to amplify neurovascular remodeling and thereby to drive neurological recovery post stroke and neural injury will be described. The potential roles of non-coding RNAs, particularly, microRNAs, and their microvesicular nano-carriers, exosomes, as potential therapeutic agents for stroke and TBI, will be discussed.

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ALEXANDRU GASNAS

Ciolac D., Pirtac I., Groppa St.


TRANSCRANIAL MAGNETIC STIMULATION (TMS) AND RESULTS OF CONNECTIVITY STUDIES IN ACUTE

ISCHEMIC STROKE

Stroke is one of the leading causes of mortality and disability in modern countries. Clinical manifestation of stroke is rapidly developing loss of brain function due to disturbance in the blood supply to the brain. Neuroplasticity, also known as cortical mapping, challenges the idea that brain functions are fixed in certain time. Neuroplasticity can act through two possible mechanisms on stroke disability-prevention and treatment of neurological deficit. Post-stroke recovery is based on plastic changes in the central nervous system that can compensate the loss of activity in affected brain regions. In particular, monohemispheric stroke is thought to result in disinhibition of the contralesional unaffected hemisphere. Neurorehabilitation programs improve function partly by enhancing cortical reorganization. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive way of producing potent changes in cortical excitability. Therefore, the application of rTMS is proposed to promote functional recovery in stroke patients, owing to the induced neuroplasticity. Functional recovery might be obtained either when rTMS is applied at low-frequency (around 1 Hz) over the disinhibited, unaffected hemisphere in order to restore defective inhibition or when rTMS is applied at high-frequency (5 Hz or more) over the affected hemisphere in order to reactivate hypoactive regions. Therefore, in the, acute or recent stroke might be a major indication of rTMS in neurological practice. Repetitive transcranial magnetic stimulation has opened a new field of investigation of the neural circuitry, and is developing into a therapeutic tool.

Keywords: cortico-spinal conduction, motor evoked potentials, electrophysiology, neurophysiology,cortical silent period, Neuroplasticity

31

MIHAIL GAVRILIUC

Adrian Bodiu, Alexandru Grumeza, Rodica Vașchevici

Chairman Department of Neurology, State Medical and Pharmaceutical “Nicolae Testemitanu” University, Chisinau,

Republic of Moldova

PHENOMENA OF PRE- AND POSTISCHEMIC CONDITIONING: THEORETICAL, EXPERIMENTAL AND

CLINICAL ASPECTS

Reduction of ischaemia injury is the aim of most treatments for cerebrovascular disease. Ischemic tolerance has been demonstrated in experimental models of cerebral ischemic stroke induced by carotid occlusion. Although many strategies have proven benefit in the experimental arena, few have translated to clinical practice. We analysed endarterectomy results of 50 patients with established ischemic stroke caused by carotid stenosis. Operations were performed under the general anesthesia. Additionally, before surgical treatment in all pacients we executed remote ischemic preconditioning that included five cycles of bilateral upper limbs 5/5 min of ischemia and reperfusion alternation. Limb ischemia was induced by inflating tourniquets 200 mmHg. Despite the skeptic expectations our results prove the amelioration of cerebral hemodynamics and also improvement of total neurological deficiency of the patients according to the scale NIHSS. The tool research included: duplex scanning of extra-cranial arteries, CT- and conventional angiography and in some cases pre- , intra- , and postoperative neurophysiological monnitoring. Although the exact mechanism of pre- and postischemic conditioning remains uncertain, its discovery merit to address to further understanding the mecanism of endogenous neuroprotection and potential new therapeutic strategies for neuroprotection in cases of brain injury. Ischaemic preconditioning could be close to becoming a clinical technique.

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VOLODYMYR GOLYK

State Institution “Ukrainian State Institute of Medical and Social Problems of Disability Ministry of Public Health of Ukraine”;

Public Organization “Ukrainian Society for Neurorehabilitation”Radyansky bstr. 1a, 49027, Dnipropetrovs’k, Ukraine

PRINCIPLES OF NEUROREHABILITATION IN VESTIBULAR SYSTEM DISORDERS

Vertigo and dizziness are not unique disease entities. After headache, it are among the most frequent presenting symptoms with lifetime prevalence around 30%. Main components of vestibular dysfunction associated with affections of different sites of the brain are: disorders of perception (vertigo/dizziness), gaze stabilization (nystagmus), postural control (postural imbalance, falling tendency) and the vegetative system (nausea/vomiting). The most frequent forms of vestibular vertigo according to outpatient clinics data are benign paroxysmal positioning vertigo, Meniere`s disease and vestibular neuritis accompanied by somatoform phobic postural vertigo, central vestibular vertigo and vestibular migraine responsible for 73.9% admissions.Vestibular system`s disorders rehabilitation is based on compensation of static and dynamic deficits. First is based on plastic events in vestibular nuclei via neurobiological mechanisms activation followed bilateral rebalance of nuclei activities and the later switch on different behavioral mechanisms using specific substitutions strategies. Practical issues of clinical applications for vestibular rehabilitation always balancing between habituation featured “don`t respond” behavior accompanied with quantitative variations and negative learning and adaptation using “different respond” activities with qualitative variations and positive learning allowing the subject gain new responses substituting for the lost functions (the best adapted to day life conditions). All strategies based on specific physical therapy approaches both individually based and goal oriented according to the type of vestibular disorder.

Keywords: vestibular disorder, vertigo, dizziness, balance, neurorehabilitation.

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STANISLAV GROPPA

Department of Neurology and Neurosurgery, “Nicolae Testemitanu” State University of Medicine and Pharmacy Chisinau, Republic of

Moldova

FEATURES OF CLINICAL POLYMORPHISM AND ETIOLOGY OF SEIZURES

This scientific work is based on video-EEG examination of the patients that took place in the Laboratory of Neurobiology and Medical Genetics, Institute of Emergency Medicine (Chisinau, Republic of Moldova). Video EEG monitoring (VEM) was made to assess the differential diagnosis of seizures, to classify the epileptic seizures or epileptic syndromes, localization of epileptic foci and antiepileptic drug selection. This study was undertaken from June 2006 to March 2015. Video-EEG monitoring was performed using a 21-channel Coherence system (Deltamed SA, Natus Medical Incorporated), including the registration of single-channel oculogram, single-channel ECG, EMG, recording of the respiratory movements of the chest. The duration of the monitoring was determined individually for each patient, and averaged between 30 minutes for a standard EEG recording, 4-8 hours for a daytime monitoring and 12-24-48-72 hours for night and long-term monitoring.Simultaneous recording with the current EEG provides indisputable diagnosis of paroxysmal events. Confirmation of the correct diagnosis allows cancellation of the unnecessary antiepileptic drugs and to choose the appropriate treatment.In our study, among patients whose clinical manifestations were recorded, based on the data obtained during the VEM, the preliminary diagnosis was changed in 39% of patients. Of the total of patients at diagnosis was changed in 39% of cases. The diagnosis changes in our patients regarding the type of epileptic seizures (partial or generalized), the diagnosis of epilepsy, epileptic manifestations and the transition from the category of unclassified seizures to classified. The diagnosis of non-epileptic seizures has been documented by VEM.

Keywords: epilepsy, epileptic seizure, EEG, VEM.

34

WOLF-DIETER HEISS

Max Planck Institute for Neurological Research, Cologne, Germany

NON-INVASIVE BRAIN STIMULATION IN REHABILITATION AFTER STROKE

The functional deficit after a focal brain lesion is determined by the localization and the extent of the tissue damage. Since destroyed tissue usually cannot be replaced in the adult human brain, improvement or recovery of neurological deficits can be achieved only by reactivation of functionally disturbed but morphologically preserved areas or by recruitment of alternative pathways within the functional network. The visualization of disturbed interaction in functional networks and of their reorganization in the recovery after focal brain damage is the domain of functional imaging modalities such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Longitudinal assessments at rest and during activation tasks during the early and later periods following a stroke can demonstrate recruitment and compensatory mechanisms in the functional network responsible for complete or partial recovery of disturbed functions. Imaging studies have shown that improvements after focal cortical injury are represented over larger cortical territories, an effect which appears to be dependent on the intensity of rehabilitative training. It has also been shown that the unaffected hemisphere in some instances actually inhibits the recovery of ipsilateral functional networks and this effect of transcallosal inhibition can be reduced by non-invasive brain stimutation.

Non-invasive brain stimulation (NIBS) can modulate the excitability and activity of targeted cortical regions and thereby alter the interaction within pathologically affected functional networks; this kind of intervention might promote the adaptive cortical reorganization of functional networks after stroke. Non-invasive brain stimulation (NIBS) uses direct current (DCS: excitation under the anode, inhibition under the cathode) or repetitive transcranial magnetic stimulation (rTMS: excitatory at high frequency, inhibitory at low frequency). Since recovery from poststroke deficits seems to be more effective in patients who recover function in the ipsilateral perilesional area, NIBS trials aimed to activate this region: this effect can be achieved by excitatory NIBS (high frequency repetitive transcranial magnetic stimulation, rTMS; intermittent theta burst stimulation, iTBS; anodal transcranial direct current stimulation, tDCS) to reactivate the perilesional area or by inhibitory NIBS (low frequency rTMS or cathodal tDCS) to reduce increased activities in the contralesional homologous areas.

DCS as well as rTMS were applied in combination with rehabilitative measures in order to improve various symptoms after stroke, especially motor deficits and aphasia. In both applications recovery was improved with combined treatment in comparison to standard therapy without NIBS. All types of NIBS were used in rehabilitation of motor deficits after stroke and positive effects on recovery were observed. Among the different modalities low-frequency inhibitory stimulation of the motor cortex in the contralateral non-affected hemisphere seems to be the most prominent approach, but large controlled trials are still missing.

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In poststroke aphasia several studies attempted to restore perilesional neuronal activity in the injured left inferior frontal gyrus by applying excitatory high frequency rTMS or iTBS or anodal tDCS to small series of patients in the chronic stage: They showed favorable effects in speech performance for several weeks to a few months. Only one study coupled ipsilesional anodal tDCS to language therapy in chronic nonfluent aphasia and observed improved speech / language performance for 1 week to 2 months. Most NIBS studies in poststroke aphasia employed inhibitory low frequency rTMS for stimulation of the contralesional pars triangularis of the right inferior frontal gyrus (BA 45) in order to reduce right hemisphere hyperactivity and transcallosal inhibition on the left Broca’s area. Most studies reported single cases or small case series with chronic poststroke aphasia without any control condition and beneficial effects on speech performance lasting for several months. Only a few controlled studies including sham stimulation were performed in chronic stage after stroke. A controlled trial with inhibitory cathodal tDCS stimulation of the non-dominant right Wernicke area in patients with subacute global aphasia resulted in some improvement of comprehension in the treatment group. In one controlled randomized study changes in PET activation pattern in the subacute course were related to the clinical improvement. The shift of the activation pattern to the dominant hemisphere induced by inhibitory rTMS over the right inferior frontal gyrus could be demonstrated in the PET activation studies and correlated to improved performance in aphasia tests. NIBS might be a treatment strategy which could improve the effect of other rehabilitative efforts.

36

DIRK M. HERMANN

Department of Neurology, University Hospital Essen, Germany

PROMOTING NEUROLOGICAL RECOVERY AND BRAIN PLASTICITY IN THE ISCHEMIC BRAIN:

OPPORTUNITIES AND CHALLENGES

Recent laboratory findings suggest that it might be possible to promote cerebral plasticity and neurological recovery after stroke by use of exogenous pharmacological or cell-based treatments. Brain microvasculature and glial cells respond in concert to ischaemic stressors and treatment, creating an environment in which successful recovery can ensue. Neurons remote from and adjacent to the ischaemic lesion are enabled to sprout, and neural precursor cells that accumulate with cerebral microvessels in the perilesional tissue further stimulate brain plasticity and neurological recovery. These factors interact in a highly dynamic way, facilitating temporally and spatially orchestrated responses of brain networks. In view of the complexity of the systems involved, stroke treatments that stimulate and amplify these endogenous restorative mechanisms might also provoke unwanted side-effects. In experimental studies, adverse effects have been identified when neurorestorative treatments were administered to animals with severe associated illnesses, after thrombolysis with alteplase, and when therapies were initiated outside appropriate time windows. Balancing the opportunities and possible risks, suggestions for the translation of restorative therapies from the laboratory to the clinic are provided.

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VOLKERHÖMBERG

Heinrich Heine University of Duesseldorf

SRH Health Center Bad WimpfenGermany

SENSE AND NONSENSE OF USING ICF IN NEUROREHABILITATION

Medicine today uses a standardized international classification of diseases (ICD). In acute medicine treatment and diagnoses of a particular disease entities,which are defined nosologically are the most important points.

As already mentioned in module 1 in rehabilitation medicine the problem is some different: Here in the foreground of interest of physicians and patients is the ability of the patient to do particular things i.e. to find descriptors for the actual abilities, function and chances of participation for the patient.

To make also such a classification comparable on an international level and find sort of a “micro language” to describe such differences in function and abilities the world health organization (WHO) has suggested to use a standardized international classification of function (ICF).

The ICF differentiates 1. Body functions and structures 2. Activities 3. Participation

In the course of rehabilitation there is a transition from the acute medical treatment of body structures and body functions towards a more functional activity and participation related view. Within the ICF nine chapters of different activities can be differentiated from elementary mobility to major live areas as social, civic and religious actvities.

Within each domain ( e.g. mobility) activities can be further sub defined into sub categories:

It will be demonstrated how ICF classification can be institute to describe rehabilitation process. Furthermore it is critically discussed in how far the micro language of ICF really reflects the patients ambitions and needs in the rehabilitation process.

It is important to note to that the ICF tries to reflect a bio- psycho- social model of disease rather than a pure biological understanding.

It will be critically discussed for what this ICF “language” is suitable or not. The relative impact of working on impairments, disabilities or handicap in neurorehab will be contrasted in the context of neurorehab as applied neuroscience.

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VOLKERHÖMBERG



MOTOR REHABILITATION: TRAINING TECHNIQUES DERIVED FROM MOTOR LEARNING KNOWLEDGE

Within the last decade there was a dramatic change in paradigms in motor rehabilitation: Physiotherapy is no longer understood as “hands on” treatment but concentrates more on “hands off” and coaching activities. The traditional “school” oriented concepts are more and more replaced by therapeutic procedures which are derived from neurobiological and neurobehavioural knowledge and are evidence based.

To further stimulate progress in the field of motor rehabilitation a fast transfer from basic neuro- and behavioural sciences into clinical practice is needed and appropriate clinical study designs and service implementations have to be defined. Most of the evidence based concepts are taking advantage from elementary rules for human motor learning.

Several evidence based therapeutic procedures can be grouped into modules to ascertain that every patient has a chance to be treated by a procedure likely to improve his condition even on a limited length of stay. So a quality proven rehabilitative therapy can be offered.

In the talk both neuroscientific principles of plasticity and motor learning as well as examples of therapeutic modules will be demonstrated.

MOTOR REHABILITATION:PHYSICAL THERAPY

The classical “spa” concept from which neurorehabilitation historically has originated ,was based on the use of hot waters , massages and other physical means providing elements of wellness along with presumptive healing effects.eg. reducing muscle spasms, pain or paraethesiae.

This lecture will summarize the most important physical therapeutic technique used in neurorehabilitation for improvement of motor function and reduction of positive sensory symptoms and discuss their differential clinical usefulness for special patients`problems.

This list will include the most useful electrical and magnetic stimulation methods,aspects of hydrotherapy and application of heat and cold.

These techniques will also be classified according to their impact on neuromodulation as a more modern concept of brain conditioning” in relation to motor learning therapy strategies.

39

VOLKERHÖMBERG



ROBOTS IN NEUROREHABILITATION. SENSE AND NONSENSE

Over the last decade intelligent mechanical training devices have been introduced into day by day clinical practice in motor rehabilitation.

The term “robots” has been borrowed from machines ( may the be android or not) designed to help man do hard work.

Therefore the term “robots” is somewhat misleading when used in the neurorehab field:These device are not designed to make therapists´s life easier or even getting rid of them completely , but are a compelling and important addenda to our motor-therapist armory which eventually will icrease productivity and effectiveness of therapists’ work.“Robots “ can open new therapeutic windows especially in severely afected patients in a very early stage of treatment, when conventional techniques are not usable ( e.g int he completely hemiplegic patient)

This review lecture will delineate the advantages of “robot” assisted training in the context of motor learning principles (high repetition rate, refined and augmented feedback properties , automatic shaping etc.) and critically discuss there relative contribution in modern evidence based motor rehab strategies.

40

PETER JENNER

NDRC, Institute of Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King’s College, London UK

NOVEL PHARMACOLOGICAL APPROACHES TO THE TREATMENT OF PARKINSON’S DISEASE

The drug treatment of Parkinson’s disease (PD) has been based around dopamine re-placement therapy for many decades. This improves motor function in early PD but many problems remain that relate the long term complications of dopaminergic thera-py, the progression of the disease process and the occurrence of non-motor symptoms of PD. In essence the changes that are occurring in drug therapy can be divided in those that affect the early stages of PD, those which are to be employed in the later more complicated stages of the illness and those which might be disease modifying.In early treatment, there has been a return to the use of L-dopa based on the results of PD-MED and STRIDE-PD trials which shows that careful early use has the best clinical efficacy and no long term disadvantage with respect to the appearance and severity of motor complications and motor fluctuations in later disease. As a consequence novel delivery forms of L-dopa are being developed along with new formulations of existing dopamine agonists.The only dopamine agonist drug that is distinguished from the others is apomorphine as it exhibits clinical efficacy equivalent to that of L-dopa. The current administration of apomorphine requires subcutaneous injection or infusion as a result of its poor oral bioavailability. As a consequence, there is particular interest in developing new forms of apomorphine to allow it to be used less invasively and to benefit from its proven clini-cal efficacy. Why apo morphine is the better dopamine agonist probably relates to its ability to interact with both D-1 and D-2 receptors and its generally rich pharmacology which needs to be explored further. Longer acting forms of L-dopa and dopamine agonists are also being developed for the treatment of ‘wearing off’ along with novel COMT inhibitors and reversible MAO-B in-hibitors. Interesting new formulations of amantadine are being studied for suppressing dyskinesia and other classes of glutamate antagonists are under investigation. Howev-er, it is the potential use of non-dopaminergic approaches to the treatment of ‘wearing off’ and dyskinesia where most effort has gone but so far with little clinical translation. One exception is the introduction of the adenosine A2a antagonist Istradephylline in to the treatment of PD for the control of ‘wearing off’.

Lastly, the search for disease modifying/neuroprotective treatments continues despite previous failures. Attacking the accumulation of α-synuclein is one such approach as is the search for drugs that modify other components of the cell death cycle that are are affected by gene defects detected in inherited forms of PD, such as parkin, LRRK2 and GBA. treatment of non-motor symptoms of PD has become a priority with an ‘as needs’ symptomatic approach being used currently as the neuronal basis of many non-motor symptoms is not clear. However, preclinical studies on cognition, sleep and autonom-ic change are starting to develop animal models in which novel pharmacological ap-proaches can be tested. One interesting approach is the repositioning of drugs already used in man for other indications but which have shown evidence for neuroprotection in preclinical studies. These include drugs used to treat type II diabetes and calcium channel blockers used in cardio-vascular disease.

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AMOS D. KORCZYN

Sackler School of MedicineTel-Aviv University, Ramat-Aviv 69978, Israel

DISEASE COURSE MODIFICATION IN PARKINSON’S DISEASE

Personalized medicine is an emerging field that encompasses the use of risk algorithms, molecular diagnostics, targeted therapies and pharmacogenomics in order to improve health care. It is expected to impact the way drugs are developed and patients are treated in many fields, including neurodegenerative diseases in the near future.Parkinson’s disease (PD) is the second most common neurodegenerative disease in man and its clinical hallmark is the motor parkinsonian features , namely rest tremor, bradykinesia, rigidity and loss of postural reflexes; These symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra pars compacta, respond well to dopamine replacement therapy; The limitation of dopaminergic therapy is that patients soon develop motor fluctuations, shortening and loss of stability and predictability of the response as well as drug-induced involuntary movements termed dyskinesias; additionally they do not provide benefit for the multiple nonmotor symptoms affecting most patients’ lives and decreasing patients’ quality of life. Moreover they do not slow down disease progression with evolution of cumulative widespread neurological disability.

In this review we will outline the applications of personalized medicine for the several stages from at risk populations to full-blown advanced PD.

We expect to change the way we currently define PD with molecular diagnostics, the use of DNA-, protein- or mRNA-based biological markers to predict the risk for developing PD as well as the molecular phenotype of ongoing PD through its various stages. Genomic analysis of diseases with homogeneous clinical phenotypes will unveil distinct molecular entities that require different treatment strategies for optimal outcomes. Furthermore molecular-targeted therapies that slow degeneration of both dopaminergic and non-dopaminergic neurons will replace those that simply treat PD symptoms, providing long-term disease course modification. Finally, pharmacogenomic data that predicts therapy response and limitations in the individual patient based on his genomic profile will accompany many drugs.

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AMOS D. KORCZYN

Sackler School of MedicineTel-Aviv University, Ramat-Aviv 69978, Israel

MEDICALLY UNEXPLAINED SYMPTOMS IN NEUROLOGY

Medically unexplained symptoms in neurology (MUS) is a heterogeneous group of disorders which lack identified biological basis and are assumed to have a psychological origin. They are diagnosed by exclusion of an organic basis, as well as exclusion of feigning. MUS symptoms can be either positive (such as “epileptic” seizures) or negative (e.g. weakness). They can be accompanied by apathy (such as “la belle indifference”) or extreme anxiety (PTSD). The assumptions that all “functional” symptoms are psychogenic, and therefore can only respond to psychiatric therapy, has not been validated.

The separation of “organic” from “psychogenic” symptoms parallels the philosophical school of dualism (vs monism), implying that some processes are due to “mental” processes which are not physical.

The diagnosis of MUS requires exclusion of malingering and factitious disorders. It is almost impossible to prove the existence of feigning, and in many cases even a “malingerer” may believe there is a justified source of the abnormality.Treatment of MUS is disappointing.

VASCULAR PARKINSONISM

Leucoaraiosis, or white matter disease of the brain, is a common affection in the elderly, and can be easily demonstrated on MRI. In addition to age, risk factors for white matter lesions (WML’s) are mainly cardiovascular ones. It is not always clear what is the pathogenetic process underlying WML’s, although a primary suspect is small vessel disease. The clinical correlates of WML’s include cognitive impairment, gait abnormalities, depression and urinary incontinence. Although the same MRI features can occur in normal elderly people, they are predictive of future appearance of gait impairment and cognitive decline. No study has yet demonstrated different MRI patterns in the different clinical syndromes.

The clinical syndrome of dementia associated with WML’s is attributed to Binswanger. In addition to cognitive impairment, however, patients with Binswanger’s disease frequenthy have gait impairment as well as urinary incontinence.

Lower body parkinsonism has also been assonciated with WML’s. This syndrome is different from idiopathic Parkinson’s disease by not involving the face and upper limbs (or only minimally), not responding to levodopa, and being predominantly symmetrical in onset. Many patients with lower body parkinsonism have, or develop, cognitive impairment and urinary incontinence.

Thus, Binswanger’s disease (BD) and lower body parkinsonism have strikingly overlapping clinical features, risk factors and neuroimaging manifestations. Therefore they could present different points on a spectrum. Long term follow-up studies of these two groups of patients may lead to a common phenotype, combining features of both. Prospective data are lacking to test this hypothesis.

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VITALIE LISNIC

Eugeniu Gavriliuc,Victor Nemțan, Octavian Misic, Olesea Odainic, Pavel Gavriliuc


ATYPICAL FORMS OF CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY

BackgroundChronic inflammatory demyelinating polyneuropathy (CIDP) is an aquired, demyelinating, motor and sensory neuropathy that is presumed to be immune mediated. The classic form of CIDP is fairly symmetric and motor involvement is greater than sensory. In our study we examined atypical forms of CIDP which are more difficult to recognize because of lack of unified diagnostic criteria.

Materials and methodsWe studied 52 patients divided into 3 groups: 20 patients with typical CIDP, 20 patients with atypical CIDP according to the EFN/PNS guideline (revised 2010) and 12 patients with sensory CIDP according to the criteria of French CIDP study group.

ResultsOur results suggest that in group of atypical CIDP prevail multifocal sensory- motor forms called Lewis-Sumner Syndrome (LSS) -56% of cases. Upper limbs are first involved in the clinical evolution of patients with LSS and not lower limbs as in typical CIDP. NCS show conduction blocks mostly in median and ulnar nerves in patients with LSS, but unaffected nerves are strictly normal. In typical CIDP NCS show evidence of demyelination in all nerve trunks. Anti-ganglioside antibodies were positive only in motor forms of CIDP. NCS is not a sensitive test to diagnose sensory CIDP, in 75% cases motor conduction velocities were not affected. SSEP is a high sensitive test to be used for underlying a possible CIDP from all sensory polyneuropathies. Overall Neuropathy Limitation Scale and 9 hole peg test are the most efficient tests to evaluate progression or regression of symptoms in patients with CIDP. Loss of myelin was the most prominent finding on biopsy. Nerve biopsy is used mainly when other studies fail to clearly establish the diagnosis of CIDP, particularly when electrophysiologic criteria for demyelination are not met. Nerve biopsy should be considered in patients with progressive, predominantly large fiber sensory neuropathy of otherwise unknown etiology, as they may have sensory CIDP that responds to therapy.

ConclusionsThere is significant phenotypic variability in the clinical spectrum of CIDP suggesting that there are differint immunopathological mechanisms at play. Future research is needed to identify disease markers to improve diagnosis and to develop new therapeutic strategies

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VITALIE LISNIC

Eugeniu Gavriliuc,Victor Nemțan, Octavian Misic, Olesea Odainic, Pavel Gavriliuc


IMPAIRMENT OF THE CENTRAL NERVOUS SYSTEM IN DEMYELINATING POLYNEUROPATHIES:

NEUROPHYSIOLOGICAL, CLINICAL AND NEUROIMAGING ASPECTS

Various case series of patients with autoimmune demyelinating disease affecting both the central and peripheral nervous system (CNS and PNS) have been reported for decades. Frequently, demyelination starts within PNS, but later CNS pathology develop, in some cases with a relapsing–remitting course. The potential mechanisms of concomitant damage of the myelin from the PNS and CNS remain unclear.

We studied 80 patients with ‘’classical” PNS demyelination (25 with acute inflammatory demyelinating polyneuropathy (AIDP) and 55 with chronic inflammatory demyelinating polyneuropathy (CIDP)) and 80 with “classical” CNS demyelination – multiple sclerosis (MS). The goal of the research was to study the clinical, electrophysiological and neuroimaging interrelations of impairment of the central and peripheral nervous system in diseases with pollard demyelinating manifestations: central and peripheral.

The research revealed the existence of a clinical-neurophysiological continuum of central and peripheral demyelination. The extremes of this clinical-neurophysiological continuum were occupied by AIDP and CIDP on one limit and MS on the other. The intermediate part of the mentioned spectrum was occupied by a syndrome of combined central and peripheral inflammatory demyelination.

The subclinical impairment of the CNS in demyelinating polyneuropathies could be detected by means of electrophysiological and neuroimaging investigations. In cases of AIDP subclinical signs of pyramidal tract impairment were established based on conduction in the pyramidal pathway by means of motor evoked potentials (MEP). The clinical impairment of the CNS was established within the CIDP pattern of symmetric proximal and distal weakness (Dimachkie MM, Saperstein DS, 2014). This form develops mainly in females, in remitting-relapsing course of the disease, with expressed degree of the motor and sensory deficit, and resistant to conventional immunosuppression treatment.

The study demonstrated that in a significant number of patients with MS subclinical signs of peripheral nerve impairment occurred. The sensory fibers of the sural and motor fibers of the peroneal nerves were more frequently involved.

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ALBERT LUDOLPH

University of Ulm; Department of NeurologyMedical director,Head of Department,Ulm, Germany

ALS GENOTYPES AND PHENOTYPES

Our epidemiological data show that about 5% of ALS patients in Germany have a family history. The majority carry the C9orf72 mutation (24%), next is the SOD mutation (13%), TBK1, FUS and TDP-43 (each about 5%) follow. Most of these mutations do not only encode mutations in the genome of ALS patients, but also of FTD patients. Therefore, the phenotype – genotype relation is poorly understood.

Recent neuropathlogical findings emphazise that staging (“Braak Staging”) for ALS is also possible. The results demonstrate that the pathology as shown by the molecular marker TDP-43 spreads from the motor cortex into the direction of the gyrus rectus and the orbitofrontal cortex. In a similar longitudinal fashion it affects the corticofugal tracts, the corticospinal tract (stage 1). the tracts to the precerebellar nuclei (stage 2), the corticostriatal tract (stage 3) and the perforant pathway (stage 4). These findings include ALS in the group of diseases which are characterized by an “initiation and propagation” pattern along anatomically defined pathways.

The translation of these neuropathological findings into phenotypes are at their beginning. However, measurement of fractional anisotropy by DTI shows that the neuropathological staging is mirrored by affection of the respective tracts. Also, spreading of the disease is a characteristic feature clinically and the predominant affection of monosynaptically supplied muscles characterize the disease. Whether these novel findings and these new concepts of ALS can be exploited therapeutically, will be show in the future.

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TUDORLUPESCU

Head of Neurology Department, “Agrippa Ionescu” Hospital, Bucharest, Romania

SYMPTOMATIC TREATMENT IN DIABETIC NEUROPATHY

The high incidence and prevalence of Diabetes Mellitus in the population represents a real matter of public health. Among diabetic patients there is a high prevalence of neuropathy. One of the most frequent symptoms encountered in this patients, and also with an important impact on quality of life, is neuropathic pain. Thus, symptomatic treatment in diabetic neuropathy is centered on management of pain. Pregabaline and duloxetine are the two drugs approved by FDA and EAM for the treatment of distal symmetric polyneuropathy. There are also other options too, including opioids, trycilclic antidepressants, SSRIs, and antiepileptics. Alpha lipoic acid has also shown pain relieving properties.

47

ION MOLDOVANU1,2

Stela Odobescu1, Lilia Rotaru1, Galina Corcea1, Oxana Grosu1, Violeta Maticiuc 1 Institute of Neurol-ogy and Neurosurgery of the Republic of Moldova, 2Medical and Pharmaceu-tical University „Nicolae Testemiţanu” of the Republic of Moldova

CHRONIC MIGRAINE ASSOCIATED WITH AUTONOMIC IMBALANCE AND OTHER RELATED COMORBIDITIES

Background: Chronic migraine (CM) is a progressive disabling brain disease; different comorbidities may influence the clinical presentation as well as some aspects of migraine pathogenesis.

Aim: to study CM relations with autonomic imbalance and other comorbidities.

Material and methods: The 4 types of comorbidities in CM were studied: autonomic imbalance (154 patients), syncope (65 patients), arterial hypertension (60 patients) and residual lateral ventricles asymmetry (62 patients). We used a large variety of methods: headache questionnaires and diaries, anxiety/depression scores, heart rate variability (HRV), trigeminal evoked potentials, tilt testing, ambulatory Holter blood pressure monitoring, pressure algometry and MRI.

Results: The study of 154 patients with CM by means of HRV analysis has shown that the abnormal increased activity of brainstem vagal centers determines the autonomic imbalance in these patients leading to its involvement in the pathogenesis of the CM itself.

The combination of CM with syncope revealed the entity of syncopal migraine and its frequent association with orthostatic intolerance syndrome as a manifestation of autonomic failure. The relation between CM and arterial hypertension was due to abnormal autonomic regulation of blood pressure diurnal changes in 60% of cases (non-dipping patients). Asymmetry of lateral ventricles has proven to be a destabilizing factor for the evolution and severity of CM.

Conclusions: Different type of comorbidities may have a different impact on CM. The autonomic imbalance, syncope and arterial hypertension appear to be involved even in the pathogenesis of CM. Residual lateral ventricles asymmetry influence the severity of the painful phenomenon only.

48

ION MOLDOVANU1,2

Victor Vovc2 1, Alexandru Cernei1, Oleg Arnăut1 Institute of Neurology and Neurosurgery of the Republic of Moldova, 2Medical and Pharmaceu-tical University „Nico-lae Testemiţanu” of the Republic of Moldova.

CONSCIOUSNESS, ALTERED STATES OF CONSCIOUSNESS AND BRAIN PLASTICITY: THERAPEUTIC PERSPECTIVES

The study of the phenomenon of consciousness (Cs) appears to be more heuristic for the analysis not only of the form of “ordinary consciousness” (subjectivity, intentionality, self-consciousness and will), but mostly of different forms of Cs as altered states of consciousness (ASC).

In ASC arise such exceptional opportunities of human beings as abolition of pain, increase of physical and mental performance, modification of the emotional perception, certain creativity insights, etc. that can be explained by a “reset” of special neurodynamic, psychophysiological and neuroplasticity processes (Moldovanu I., Vovc V., 2012, 2013).

Consciousness influence brain neuroplasticity during both wakefulness and sleep. This means that Cs indeed activates synaptic flow, brain structures changes and functional organization (Askenasy J. and J. Lehmann, 2013). In recent years to explain the phenomenon of Cs some concepts of quantum physics are used (Hameroff S., Penrose R, 2014).

Our goal is to present a novel approach for research of the phenomenon of Cs based on several important strategic issues:

a) to study certain forms of Cs - ASC. b) to quantify the phenomenological structure of consciousness in ASC (Pekala R., 1991, Dittrich A et al. 2005). c) ASC will be induced by various ways using neurostimulation techniques (as binaural sound stimulation, transcranial electrical stimulation, etc.). d) plasticity and neuroprotection study will be an essential component of our research.

So, altered states of consciousness appear to be an “interface” between ordinary consciousness and unconsciousness of the human being and it seems to have major therapeutic potential.

49

DAFIN F. MUREȘANU

Chairman Department of Clinical Neurosciences, University of Medicine and Pharmacy “Iuliu Hatieganu”,Cluj-Napoca, Romania

ADVANCES IN NEUROREHABILITATION FUNDAMENTALS - AN UPDATE

Brain damage have a negative impact on all three levels of structural and functional organization: cellular and molecular level, circuitries level and dynamic network level and launches an endogenous continuous brain defense response which consists in neuroprotection (the immediate response) and neurorecovery (a later response).

Endogenous neuromodulation represents at the cellular and molecular level the optimization of common biological processes that could potentially generate cell death or promote neurodegeneration. At the circuitries and dynamic network levels, it represents the tendency in reinbalancing of functional connectivity in resting-state netwoks.

In the last years, there has been a substantial effort in understanding the brain functioning and how to enhance endogenous neuromodulation and neurorehabilitation in general, by using a large spectrum of neurotechnologies such as imaging techniques (functional magnetic resonance imaging, ligant-based positron emission tomography, diffusion-tensor imaging), quantitative electroencephalogram, magnetoencephalography, eye tracking, optogenetics, transcranial magnetic stimulation, transcranial direct current simulation, deep brain simulation, computational neuroscience and brain-computer interfaces. The combination between these technologies provide valuable information about the structure-function relationship underling resting-state networks, about the dynamic cross-talk between networks and about the abnormalities in the functional connectivity in different pathologies.

50

DAFIN F. MUREȘANU


RESULTS FROM A LARGE RETROSPECTIVE COHORT TRIAL IN TBI

TBI is a field with many unmet needs in medicine and public health. It is a major cause of death and disability and also leads to huge direct and indirect costs to society. Currently the incidence of TBI is increasing.

TBI populations are heterogeneous in terms of mechanism of disease, baseline prognostic risk factors, clinical severity and evolution. This heterogeneity generates complex challenges.

New pharmacological approach together with more basic and clinical research is needed for better targeting TBI therapy to the individuals.

The frequent progression of contusive brain injury indicates that this may constitute a subpopulation of TBI more likely to benefit from acute neuroprotection (in the classic sense) by limiting processes involved in secondary brain damage.

Other mechanisms, and consequently different approaches may be more relevant in patients with diffuse axonal injury, and neuroprotection in a more broad sense also includes strategies and therapies aimed at promoting regeneration or replacement of lost neuronal and glial cells, neuronal circuits, and stimulation of neuroplasticity (neurorecovery).

The primary goal of pharmacological support in TBI is to reduce secondary damage (neuroprotection) and to enhance repair (neurorecovery).

The current presentation will highlight the limits of monomodal drugs, the advantages of multimodal drugs and the results of a large retrospective cohort trial with Cerebrolysin in traumatic brain injury.

51

DAFIN F. MUREȘANU


THE ROLE OF NEUROTROPHIC FACTORS IN BRAIN PROTECTION AND RECOVERY AFTER STROKE

This presentation briefly reviews some of the mechanisms involved in the pathogenesis of neurological diseases, i.e. damage mechanisms, and their interactions and overlap with protection and reparatory processes (i.e., endogenous defense activities). A relationship between damage mechanism (DM) and endogenous defense activity (EDA) regarding therapy principles will also be described.

Currently, it is difficult to find the correct therapeutic approach for brain protection and recovery, especially because we do not fully understand all of the endogenous neurobiological processes, the complete nature of the pathophysiological mechanisms and the links between these two categories. Moreover, we continue to use a simplistic and reductionist approach in this respect.

Endogenous neurobiological processes, such as neurotrophicity, neuroprotection, neuroplasticity and neurogenesis, are central to protection and recovery and represent the background of EDA.

The biological reality of the nervous system is far more complex. In fact, there is an endogenous holistic process of neuroprotection and neurorecovery that should be approached therapeutically in an integrated way.

The current tendency to exclusively frame drug activity in terms of single mechanisms and single focus effect might distract from other paradigms with greater explanatory power and hinder the development of more effective treatment strategies. A change of concept is required in pharmacological brain protection and recovery. Some prospective considerations including an integrated pharmacological approach, focusing on drugs with multimodal activity and pleiotropic neuroprotective effect which are biological drugs, rather than single mechanism drugs, which usually are chemical drugs will be highlighted.

Biological agents (e.g., neurotrophic factors and related molecules) with modulating and multimodal effects are better pharmacological agents for brain protection and recovery, because they usually have also pleiotropic neuroprotective effect. That is why they are capable of pharmacologically bridging acute neuroprotective processes with the long-term recovery processes in stroke, TBI and neurodegenerative disorders.

This presentation will also focus on important therapeutic results of Cerebrolysin treatment in stroke and TBI.

52

ADRIANA SARAH NICA

Head of Neurology Head of Rehabilitation Department,University of Medicine “Carol Davila”Bucharest, Romania

NUTRITIONAL CARE OF NEUROLOGICAL DISABLED PATIENTS

There is an increasing number of neurological patients (stroke, MS, ALS) with impaired nutrition which can exist before the appearance of disease or during the rehabilitation period, this issue is central to the evolution of the patient.

Consequences registered by raising morbidity and mortality from cardiovascular diseases (hypertension, diabetes, decreased insulin resistance) showed that the program of prevention and treatment respectively in those situations are closely linked to nutrition, especially for inpatient neurological rehabilitation.

Monitoring and evaluation of obesity, malnutrition, energy and fluid intake are essential directions in therapeutic rehabilitation program and patient education.

In the presentation are reviewed patient’s evaluations for clinical and anthropometric indices, classification of obesity, disorders malnutrition-type. At the same time are presented therapeutic aspects related to changes in weight, diet and nutrition principles, elements on the functional capabilities and physical consequences such as muscle changes, edema, trophic disorders. This paper presents the justification for importance of energy and fluid intake and enteral nutrition.

In the center of the presentation, the emphasis is on neurological disabled patient education practices on diet, nutrition, individual adaptations in various psycho-behavioral aspects. Also an important aspect represents education of caregivers regarding nutrition principles, taking into account that many neurological patients depend on them for conducting daily activity living.

53

IOAN ONAC

Chair of Balneophysical Therapy and Medical Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”,Cluj-Napoca, Romania

CLINICAL AND THERAPEUTIC ASPECTS IN LUMBAR SCIATICA BY DISC HERNIATION

Lumbar sciatica represents a form of clinical manifestation of a peripheral motor neuron syndrome in the low back pain, most frequently having a mechanic disc etiology, characterized by dermatome distribution aggravated by flexion and Valsalva maneuver, with monoradicular neurologic deficit in 50% of cases. Annual costs of treatments are impressive, ranging at billions of Euros/US dollars annually. Properly treated it has a high healing potential within 3 month from beginning (60-80%), untreated it is prone to chronic pain. Severe forms with ponytail syndrome require neurosurgical treatment. Current guidelines recommend positive diagnosis of sciatica in the presence of a typical radicular pain, lower limb irradiated and at least one neurological test (sign) indicating nerve root damage or characteristic neurological deficit, excluding warning signs (“ red flags “) , both anamnesis and physical examination.

Computer tomography (CT) and magnetic resonance imaging (MRI) have both the needed accuracy for the diagnosis of disc herniation.

Initial treatment is conservative, with a major focus on patient education (see the clinic guide of the Dutch College of General Practitioners). It recommends relative rest with continuing normal activity, combined with drug therapy (NSAIDs, analgesics, muscle relaxants, general corticotherapy or paravertebral , epidural, infiltration, sedatives).

Surgical treatment (discectomy ‘the golden standard’ in the herniated disc) is reserved for severe cases with ponytail syndrome or if clinical symptoms persist after 6-8 weeks of treatment.

Regarding the optimal treatment and application timing, no definite conclusion was reached yet.

No significant differences appeared in the evolution of patients treated surgically compared with those treated conservatively, on the long term of 1-2 years.

54

GELU ONOSE

The University of Medicine and Pharmacy ”Carol Davila” – Bucharest, Romania

The Teaching Emergency Hospital ”Bagdasar-Arseni” – Bucharest, Romania

PROPAEDEUTICS FOR REHABILITATION IN THE CENTRAL NERVOUS SYSTEM TRAUMATOLOGY

(POSTACUTE/ SUBCHRONIC STAGES)

Central nervous system (CNS) traumatology provides, likewise all the severe CNS lesions – mainly because currently there is no cure for them – devastating consequent conditions/ sequels, often including with most serious/ life-long disabilities [mainly of the following kinds: motor/ neural-muscle (tone and/or trophicity), coordination, balance, sphincter/s control, sensitive and/or sensory/al (especially for some brain ailments), swallowing, cognitive/ consciousness, and/or communication, respectively emotional/ behavioral] thus being a harsh burden – but at the same time, challenge – for the affected individuals, their kin and/or care takers, and for the society, as well.

The modern clinical management of patients with postacute/ subchronic conditions following severe CNS – including traumatic – lesions, is complex, entailing (in addition to neurosurgical and/or of intensive care type intervention/s, if necessary) endeavors for balanced: pharmacological, physical-kinesiological (including rehabilitation nursing), speech and/or cognitive-behavioral, therapies.

In order to reach as consistent as possible neurorehabilitative and neurorestorative outcomes, professionals who work in this very difficult domain must get, and have constantly up-dated, (including) solid preliminary/ propaedeutical knowledge on: definitions and epidemiologic data regarding CNS traumas, major consequent conditions and dysfunctions/ disabilities, morph-/phys-pathological underlying lesions’ mechanisms (including as intimate therapeutic, rehabilitative targets), instruments for clinical/ para-clinical and functional evaluation – used to identify neurorehabilitative related indications, respectively to assume prognostic estimations, to set specific, realistic/ appropriate goals and/or to assess the results obtained.

In this work/ invited lecture, the above mentioned subject matters will be systematically and integratively approached.

Keywords: propaedeutics, CNS traumatology, serious/ life-long disabilities, neurorehabilitation, postacute/ subchronic stages

55

CRISTIAN FALUP-PECURARIU

Department of Neurology, County Emergency Clinic Hospital, Faculty of Medicine, Transilvania University Brașov, Romania

PAIN AND SLEEP DISTURBANCES IN PARKINSON’S DISEASE

Pain is a frequent non-motor symptom. The prevalence varies between studies because of the criteria and definitions used. There were many attempts for pain classification in PD. The pathophysiology involves basal ganglia in nociceptive pathways, the cortical-basal ganglia-thalamic circuit in modulation of pain. The major categories of pain are: musculoskeletal, dystonic, neuropathic, central. There are data that pain is one of the most bothersome PD related symptom/condition in early and also advanced PD. Frozen shoulder, radicular and nonradicular back pain are more frequent encountered in PD. Treatment involves a complex approach with pharmacological treatment, physical therapy, injections of botulinum toxin.

Sleep disturbances in Parkinson’s disease (PD) are: insomnia, REM sleep behavior disorder, restless legs syndrome, excessive daytime sleepiness. All sleep disturbances have higher prevalence comparing with normal control groups. Insomnia is more prevalent in advanced disease comparative with early disease. However, large epidemiologic studies suggested that insomnia is more prevalent as pre-motor symptom. Excessive daytime sleepiness (EDS) has been shown in cross sectional studies to be present in 30-50% of the PD patients. The prevalence is increasing in longitudinal studies. There are multiple factors involved in EDS: intrinsic to PD, effects of drugs, nocturnal sleep disorders. REM sleep behavior disorder with abnormal dreams, dream-enacting behaviors, could be a premotor feature or could appear during the evolution of PD.

56

CRISTIAN DINU POPESCU1

D. Muresanu2

C. Bohotin1

V. Bohotin3

1. “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania

2. “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj Napoca

3. Service de Neurologie, Les Hôpitaux des Chartres“

IMPORTANCE OF MOTOR AND PHARMACOLOGICAL INTERVENTIONS IN STROKE REHABILITATION

Stroke can have devastating effects on neurological function and is often the cause of persistent disability. Recovery is incomplete in many cases, and long term intervention is needed. The fundaments of functional recovery are neuroplastic processes - they are triggered both by the inbalance caused by the stroke and by the attempts to move and to regain control over the affected limbs. Rehabilitation aims to enhance and optimize natural processes that occur in the injured brain. Neuroplasticity is an active process and is can be identified on all structural levels of the brain – starting from the mollecular layer and culminating with the functional networks and regions. Both motor learning and pharmacologic intervention have the potential to modulate neuroplasticity. Cortical function can be evaluated through transcranian magnetic stimulation. To illustrate the impact of pharmacologic intervention on cortical dynamics in stroke we present the added effect of Cerebrolysin (a neurotrophic factor) to conventional rehabilitation on 18 subjects with recent middle cerebral artery ischemic stroke (2-12 weeks). Patients that have received Cerebrolysin for 10 days have significantly larger amplitudes of the motor evoked potential and diminished treshold values on the lesioned hemisphere, as well as a more important enlargement of the hand projection area as compared with the control group. This prooves a potentiating effect of the pharmacologic intervention on the cortical mechanisms involved in rehabilitation.

57

CRISTIAN DINU POPESCU1,2

D. Alexa1,2

D. Baltag2

Cristina Grosu1,2

1. Student Physician, University of Medicine and Farmacy “Grigore T.Popa”- Iasi, Faculty of Medicine

2. Neurology Clinic, Rehabilitation Hospital Iasi

LEVODOPA—CARBIDOPA INTESTINAL GEL AND BRAINSTEM AUDITORY EVOKED POTENTIALS IN

ADVANCED PARKINSON’S DISEASE

The aim of this paper is to analyze the influence of continuous dopaminergic stimulation on functional connectivity in brainstem evaluated by auditory evoked potentials in patients with advanced Parkinson’s disease.

Material and methods. The paper is a prospective study of 25 patients with Parkinson’s disease, two of them in stage Hoehn and Yahr 3 and the others 23 in stage 4. The evaluations was done before and after 10 days of treatment with with levodopa/carbidopa intestinal gel.

Results. Inspection of the absolute values of waves I, III, and V finds that the patients in OFF state before L-dopa/carbidopa gel infusion present significant increases in waves III and V that occur at 4.26 and 6.30 msec while wave I is normal at 1.75 msec. The latencies after duodopa therapy are well within normal limits at 1.76, 3.80 and 5.62 ms

Conclusion. Our results indicate that functional connectivity in brainstem showed a significant increase possibly due to the dopaminergic continuous stimulation action on dysfunctional communication within the motor network in Parkinson’s disease.

58

PETER RIEDERER

University of Würzburg, Medical School, Germany

VIRUS AND PARKINSONISM

Although the interaction of viral infections with brain structures is well known and explicit since the pandemic influenza some 90 years ago which gave rise to postencephalitic parkinsonism, the interaction of virus at the level of transmitters is not fully understood. Although there is a lack of virus particles in cases of encephalitis lethargica, more recent experimental data with H5N1 virus infected C57BL/6J mice indicate virus transport from peripheral nervous system to CNS, α-Synuclein aggregation and microglia activation, classical signs of PD.

Loss of neurons in the Substantia nigra (SN) has been initiated by H5N1 and in other experimental studies using simian immunodeficiency (SIV), a rhesus monkey model for HIV parkinsonism. Interestingly enough, L-Dopa and selegiline restored the dopamine deficiency but aggravated the SIV-induced pathology. As a consequence, treatment strategies for HIV-infected patients with parkinsonism must be reconsidered if the need for antiparkinsonian treatment is indicated.

59

MARINA SANGHELI1,2

Marina Sangheli1,2

Vitalie Lisnic1,2

Mihail Gavriliuc1,2 Olesea Odainic2

Larisa Chetrari2

Svetlana Pleșca2

Cristina Marcoci1,2

Anna Belenciuc1,2

1. Department of Neurology, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Republic of Moldova

2. Institute of Neurology and Neurosurgery, Republic of Moldova

EPIDEMIOLOGICAL STUDY OF MULTIPLE SCLEROSIS IN THE REPUBLIC OF MOLDOVA

Background: Multiple sclerosis (MS) is the most common cause of neurological disability in young adults worldwide and about half of those affected are from Europe. The geographical distribution of MS is heterogeneous, but it is well known that the disease is more prevalent in temperate zones than in the tropics, with significant variations between regions of the same latitude, even within the same country. An interaction of environmental and genetic factors is thought to trigger the development of MS.

Aim: To investigate epidemiological and clinical data of multiple sclerosis in the Republic of Moldova, including gender and age specific trends, taking into account the fact that the natural evolution of the disease is not yet influenced by the use of disease-modifying drugs.

Methods: 747 MS patients were included in the study. McDonalds’ Criteria (2010) was used to establish the diagnosis. All data from the different epidemiological sources was incorporated into a single dataset. The demographic and clinical data collections were performed using a paper form of questionnaires completed by a retrospective analysis of hospital records.

Results: On December 31st 2012, 747 patients were residing in the study area. Of 724 prevalent patients, 460 (63,5%) were female, mean age of 42.1±11.9 years and 264 (36,5%) were male, mean age 40.8±12.8 years. The crude onset-adjusted prevalence was 21.0 per 100,000 (95%CI: 14.8-27.1) and the standardized prevalence 20.2. A higher number of MS patients was recorded for the rural (72.6%) than in the urban area (27.4%) as well as for the administrative area of the North (33.8%) in comparison with the South (11.1%).

Conclusion: This study supplies a wide picture of the age and gender-specific prevalence of MS throughout the Republic of Moldova, standardized to European population. The higher frequency of all manifestations on 31st December 2012 reflects the worsening of the disease, which proves the disease progression and necessity of disease-modifying therapy.

60

STEPHEN D. SKAPER

Massimo Barbierato, Carla Marinelli, Laura Facci, Pietro Giusti

Department of Scienze del Farmaco, Università degli Studi di Padova,Italy

CO-ULTRAMICRONIZED PALMITOYLETHANOLAMIDE/LUTEOLIN PROMOTES MATURATION OF RAT CORTICAL

OLIGODENDROCYTES

Oligodendrocytes are the myelin-producing cells of the central nervous system responsible for ensheathment of axons. Oligodendrocytes have limited ability to repair the damage to themselves or to other nerve cells, as seen in demyelinating diseases, such as multiple sclerosis (MS). MS lesions are characterized by the presence of undifferentiated oligodendrocyte precursor cells (OPCs), highlighting their inability to mature into myelin-producing oligodendrocytes. Thus, an important strategy may be to replace the lost oligodendrocytes and/or promote their maturation or proliferation. N-palmitoylethanolamine (PEA) is an endogenous fatty acid amide belonging to the N-acylethanolamines family. Studies demonstrate PEA to possess analgesic, anti-inflammatory, and neuroprotective actions. More recently, a composite of co-ultramicronized PEA and the flavonoid luteolin (co-ultraPEA/Lut, 10:1 by mass) was shown to be more efficacious that PEA alone in improving outcome in experimental models of spinal cord injury and traumatic brain injury. Here, we examined the ability of co-ultraPEA/Lut to promote progression of OPCs into a differentiated phenotype. OPCs were prepared from newborn rat cortical mixed glial cell cultures as described, and treated the following day with 10 μM co-ultraPEA/Lut. Cells were collected 1, 4 and 8 days later and analyzed for expression of myelin basic protein (MBP). Real-Time Polymerase Chain Reaction and Western blot analyses revealed a time-dependent increase in expression of both mRNA for MBP and MBP content by immunoblotting. Treatment with either ultramicronized PEA or luteolin was ineffective. Co-ultraPEA/Lut also promoted morphological development of OPCs. Co-ultraPEA/Lut may represent a novel pharmacological strategy to promote OPC maturation.

Supported by MIUR, PON ‘Ricerca e Competitività 2007 - 2013’ (PON01_02512)

61

JOHANNES THOME

UniversityMedicine of Rostock,Rostock, Germany

USING CLOCK-GENE RELATED MECHANISMS IN THE TREATMENT OF NEUROPSYCHIATRIC DISORDERS

Rhythmical circadian alteration of physical functions, including those involved in neural activity and behaviour, is a universal phenomenon whose underlying cellular and molecular basis is regulated by so-called CLOCKgenes. In principle, these CLOCK genes are able to regulate the expression of other genes in a strictly non-random, time-dependent, repetitive manner. While knowledge about the exact mechanisms of CLOCK-gene effects is rapidly increasing, more and more neuropsychiatric disorders are identified which coincide with profound pathological alterations of sleep, circadian rhythmicity and CLOCK-gene regulation. Therfore, targeting CLOCK-gene related mechanisms is a promising strategy in order to develop innovative and effective treatment options for such widespread and devastating conditions as dementia and neurodevelopmental disorders (ADHD, ASD) and other neuropsychiatric disorders.

62

IOAN VERESIU

“Iuliu Hatieganu” University of Med and Pharm Cluj-Napoca. Department of Diabetes, Nutrition and Metabolic Diseases,Romania

ARE THERE EVIDENCES FOR PATHOGENESIS-BASED APPROACH OF DIABETIC NEUROPATHY?

Diabetic neuropathy (DN) is considered as the most frequent chronic complication of diabetes. In a recent study (Veresiu IA et al, Journal of Diabetes Complications, 2015 ), we have sown that more than two thirds of the patients from our country declare about themselves that they have this complication with an important impact on their quality of life. Peripheral DN is also the most important risk factor for foot ulcerations and lower limb non-traumatic amputations and autonomic DN is an important predictor for early mortality. In spite of fact that we have several options for the symptomatic treatment of painful DN, the “disease modifying” strategy continues to challenge the researchers and the practitioner also. One by one, the different hypothesis, as the aldose reductase inhibition for blocking excessive polyol production, inhibition of some potentially harmful fatty acid synthesis (e.g. gamma-linolenic acid), protein kinase C inhibition and some nerve growth factors manipulation, failed to fulfill expectations. Probably the very complex interplay of many metabolic and vascular mechanisms involved in the DN pathogensis, and the lack of reliable targets for different therapeutic interventions, are some of the explanations of this situation. A very tempting hypothesis is that proposed (and experimentally proved) by Brownlee M et al (Nature 414:813-820, 2001), the so called “unifying mechanisms”, based on transketolase activation effect of benfothiamine and redirection of harmful glycolitic products to pentoso-phosphate pathway. A well done, double blind, placebo-controlled study (Stracke H et al, Exp Clin Endocrinol Diab, 116, 600-605, 2008) showed significant improvement on some symptoms of peripheral DN. Another “disease modifying” approach is based on powerful antioxidant effect of alpha-lipoic acid. There is a published meta-analysis of the studies with alpha-lipoic acid (Ziegler D et al, Diabet Med 21:114-121, 2004) showing symptomatic benefits of these treatment. The good risk-benefit and cost-benefit ratios are also in the favour of these two strategies.

63

JOHANNES C. VESTER

Senior ConsultantBiometry andClinical Research

idv - Data Analysis andStudy Planning,Germany

IS THERE A CHANCE FOR CLINICAL RESEARCH IN NEUROREHABILITATION WITHIN THE FRAMEWORK OF

EVIDENCED-BASED MEDICINE?

CLASSIC AND NEW APPROACHES

Evidence-based practice knocks on the door of clinical research in neurorehabilitation. The clinical trial is the mechanism for comparing and testing therapeutic interventions to determine their effect in human subjects and thus their value in rehabilitation practice (Terrin, 2003, Behrman 2013). But how are the chances to improve therapeutic concepts within the demanding framework of evidenced-based medicine? Classic approaches based on the single criterion paradigm and modern approaches based on the multidimensional approach are discussed with examples from different fields of neurorehabiliation.

64

AUREL POPA-WAGNER

Department of Psychiatry, University Medicine of Rostock, Rostock, Germany

COMBINATION OF GRANULOCYTE COLONY-STIMULATING FACTOR WITH AND BM MSC AND BM MNCS

FOR STROKE TREATMENT IN AGED RATS IS NOT SUPERIOR TO G-CSF ALONE

Attractive therapeutic strategies to enhance post-stroke recovery of aged brains include methods of cellular therapy that can enhance the endogenous restorative mechanisms of the injured brain. The translational failure of experimental therapies might hence at least partially be related to monotherapeutic approaches, not ideally addressing potential counter-mechanisms to their full extent or within the best time window. For example, therapeutic effect relying on stem/progenitor cell mobilization by granulocyte-colony stimulating factor (G-CSF) require about a week to become manifest, which is potentially beyond the optimal timing. Here, we tested the hypothesis that treating post-stroke aged rats with the combination of bone marrow-derived mononuclear cells (BM MNC) or bone marrow-derived mesenchymal cells BM MSC and G-CSF improves the long term (56 days) functional outcome by compensating the delay before G-CSF comes to full effect. To this end, 1x106 syngeneic BM MSC and BM MNC per kg bodyweight (BW) in combination with G-CSF (50µg/kg, continued for 28 days) were administered via the jugular vein to Sprague-Dawley rats six hours post-stroke. Infarct volume was measured by magnetic resonance imaging 3 and 48 days post-stroke and additionally by immunhistochemistry at day 56. Functional recovery was tested during the entire recovery period. Daily G-CSF treatment led to robust and consistent improvement of neurological function, but did not alter final infarct volumes. The combination of G-CSF and BM MNC, did not further improve post-stroke recovery. The lack of an additional benefit may be due to an hitherto not well investigated interaction between both approaches and, to a minor extent, to the insensitivity of the aged brains to regenerative mechanisms. Also considering recent findings on other tandem approaches involving G-CSF in animal models featuring relevant co-morbidities, we conclude that such combination therapies are not the optimal approach to treat the acutely injured aged brain.

65

DANIELA EFREMOVA

Eremei Zota,Daniela Efremova, Chiforişina V, Groppa. St

Neurologist at Neurology Department of National Scientific Practice Center of Medical Emergencies. Chisinau, Moldova

RISK FACTORS AND SECONDARY PREVENTION OF ISCHEMIC STROKE IN THE POPULATION OF MOLDOVA

Stroke is one of the leading causes of morbidity and mortality worldwide. In the Republic of Moldova stroke mortality rate remains one of the leaders in Europe. Stroke incidence rate increased from 20.4 in 2000 to 28.19 in 2008 to 100.000 population. Stroke is the first cause of disability among adults in the Republic of Moldova, 13% of stroke patients being of working age. Also it is the second cause of dementia and the most common cause of epilepsy in the elderly, as well as a fairly frequent cause of depression. The importance of the problem is determined by social and economic impact caused by stroke.

Each year 800 persons in a population of 1 million suffer recurrent stroke (33% of all strokes). At least 1 in 3 people who’ve had a TIA will have a stroke within 5 years. All these are potentially avoidable by effective management of risk factors and secodary prevention. Also recurrent strokes are more likely than initial strokes to result in disability and death. Study rezults will permit elaboration of secondary prevention strategies with the purpose to minimize stroke impact on the population of the Republic of Moldova.

Keywords: Stroke , secondary prevention, management

66

ANDREAS ZWERGAL

Department of Neurology, German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences, University Hospital Munich, Germany

NEUROOTOLGY UPDATE

Over the last years the insight into pathophysiology and treatment of the most frequent vestibular disorders has markedly increased. However, the diagnostic criteria are still not standardized and prospective treatment trials are still lacking.

Peripheral vestibular disorders are the most common cause for vertigo and dizziness. Bilateral vestibulopathy can be reliably diagnosed by the head-impulse test, caloric irrigation, and vestibular-evoked myogenic potentials. A new frequent subtype has been described: cerebellar ataxia, neuropathy, and vestibular areflexia syndrome. Benign paroxysmal positioning vertigo (BPPV) can be easily diagnosed and effectively treated. Vitamin D deficiency may be a risk factor for recurrent BPPV. Vestibular neuritis is most likely caused by the reactivation of a herpes simplex type 1 infection; the inferior vestibular nerve subtype is now well established. More evidence is needed that the recovery can be improved by corticosteroids. Symptomatic treatment with antiemetic drugs in vestibular neuritis should be given on demand and for a short time. Endolymphatic hydrops in Menière’s disease can be depicted by high-resolution MRI after transtympanic gadolinium injection; a high-dosage and long-term prophylactic treatment with betahistine is evidently effective. Its mechanism of action is most likely an increase in the inner-ear blood flow. Vestibular paroxysmia is now a well established entity; carbamazepine is the treatment of first choice. Superior canal dehiscence syndrome can be reliably diagnosed; the best current treatment option is canal plugging.

Central lesions can also induce vertigo, dizziness and balance disorders. An acute lesion in the entrance zone of the vestibular nerve, the vestibular nucleus or cerebellum may mimick peripheral lesions and can only be differentiated by an exact neuro-opthalmological exam including testing for skew deviation, gaze-evoked nystagmus and head impulse pathology. Chronic cerebellar degeneration may induce ocular motor disorders like downbeat nystagmus (DBN) and dysfunction of posture and gait. DBN is generally caused by a bilaterally impaired function of the cerebellar floccular lobe due to neurodegenerative disorders. A randomized double-blind cross-over trial of 4-AP in DBN showed a reduction in slow phase velocity of DBN by half and an improvement of visual acuity at a dosage of 5mg 4-AP four times a day.

Vestibular migraine is the most common cause of central recurrent attacks of vertigo. Characteristic features include recurrent attacks of various combinations of vertigo, ataxia of stance and gait, visual disorders, and other brainstem symptoms accompanied or followed by occipitally located head pressure, pain, nausea, or vomiting. Treatment is the same as for migraine with aura, i.e., for prophylactic therapy the use of betablockers (metoprolol or propranol), valproic acid or topiramate for at least six months. There is an on-going a placebo-controlled multi-center trial (metoprolol 95 mg per day versus placebo; the PROVEMIG- trial).

Although progress has been made in the diagnosis and treatment of most vestibular disorders, more state-of-the-art trials are needed e.g. on the treatment of bilateral vestibulopathy to prove the efficacy of balance training, of vestibular neuritis (in terms of recovery of peripheral vestibular function and central compensation), of vestibular paroxysmia to prove the effects of carbamazepine, and of Menière’s disease to find the optimal dosage of betahistine. Recently, a European Network for Vertigo and Balance Research, called DIZZYNET, was established to run these multicenter prospective clinical trials.

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CURRICULUM VITAE

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University studiesα 1990: Faculty of Dental Medicine, „Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napocaα 1999: Faculty of Medicine, „Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca

Postgraduate specializationα Oral and maxillofacial surgery

Postgraduate trainingα Oral Implantology, 1994α Microsurgery, 1994α International Cancer Management Course, 1998α Competence course in maxillo-dental radiodiagnosticα Ultrasonographyα Orthognathic surgeryα Lasertherapy

PhD degree α „Value of ultrasonography in maxillofacial surgery”, University of Medicine and Pharmacy Cluj-Napoca, 2003

Position heldα Professor, Department of Maxillofacial Surgery and Implantology, Faculty of Dental Medicine, University of Medicine and Pharmacy Cluj-Napoca since 2007

Scientific and professional societiesα Founding member of the Romanian Society of Reconstructive Microsurgeryα Vicepresident of the Romanian Society of Oral and Maxillofacial Surgery (SRCOMF)α Member: • RomanianSocietyofAngiologyandVascularSurgery1991 • InternationalAssociationofOralandMaxillofacialSurgeons(IAOMS)1994 • EuropeanAssociationofCranio-MaxillofacialSurgery(EACMFS)1994 • AssociationofTransylvanianDermatologists1996 • RomanianSocietyofPlasticandEstheticSurgery2001 • RomanianSocietyofUltrasonographyinMedicineandBiology1998 • RomanianSocietyofOralImplantologyandBiomaterials2000 • RomanianSocietyofLasersinDentistry2003

Scientific activity • Scientificarticlesandstudies-190papers • Booksandtextbooks-10booksauthoredandcoauthored • Paperscommunicatedinconferences–71papers

MIHAELA BACIUT/Romania

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Other professional activitiesα Member of the Editorial Board Journal of Cranio-Maxillofacial Surgery – the official journal of the European Association of Cranio-Maxillofacial Surgery α Member of the editorial boards: • Dento-Medica(Sibiu,Romanian–FrenchDentalAssociation, “Victor Papilian” Faculty of Medicine 1996 • QuoVadis(Cluj-Napoca,HumanitarianFoundation“Hipocrate”1997 • RomanianJournalofUltrasonography1999 • TransilvaniaStomatologică2001

Other positions held Member in 15 scientific committees

Domains of research and interestα Stem cell based regenerationα Craniofacial surgery of complex congenital malformationsα Orthognathic surgery of facial deformities and asymmetryα Oral implantologyα Biomaterialsα Medical rapid prototyping and medical imaging to optimize healthcare systemsα Craniofacial bone reconstruction and regeneration α Osteogenesis using callus distractionα Lasertherapyα Craniofacial ultrasonography

Research projects – national and international - 22

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1983 : M.D. at the Faculty of Medecine of University of Medecine and Pharmacy “Carol Davila” Bucharest1983-1985 : post graduate hospital stagium in University Hospital of Emergency Bucharest1985- 1989 : resident of neurology 1985 : assistant professor – University of Medicine and Pharmacy “Carol Davila” Bucharest- Department of Neurology of the University Hospital of Emergency Bucharest1989 : specialist in neurology, confirmed by the Ministery of Health of Romania1993 : Ph.D. at the University of Medecine and Pharmacy “Carol Davila” Bucharest - senior lecturer of neurology - Head of Department and Medical Chief (University Hospital of Emergency, Bucharest1994 - 1999 : Associate Professor of Neurology 1999 (since) : Professor of Neurology at the University of Medicine and Pharmacy ” Carol Davila” Bucharest and Chairman of the Neurology Department of the University Hospital of Emergency Bucharest2006: : Doctor Honoris Causa - University „Ovidius” – Constanta ( Romania )2011 : Director of Department of Clinical Neurosciences - University of Medicine and Pharmacy ” Carol Davila” Bucharest2013 ( since) : Corresponding member of the Romanian Academy of Medical Sciences

Other professional activities :

2000-2004 : Vice-Dean of the Faculty of Medecine - University of Medecine and Pharmacy “ Carol Davila” Bucharest2001-2013 : President(founder) of the Romanian Society of Neurology2013(since) : Honorary President ad vitam of the Romanian Society of Neurology2003-2009 : member of the Scientific Committee of ECTRIMS 2005-2009 : member of the Executive Committee of the European Society of Neurology2011 (since) : member of the National Committee of Habilitation of the Romanian Ministery of Education for PhD accreditation and high academic degrees

Post graduate training :

1992 - 1994 : post graduate training in clinical neurology and functional investigations of the nervous system at University “ Rene Descartes”(Paris) : C.H.U. Sainte-Anne (Neurology) and C.H.U. Cochin – Port Royal (Functional Investigations of the Nervous System) and training in neuroendocrinology 1996 : second medical competence (confirmed by the Ministery of Health of Romania) in “Diagnosis in Neurological Diseases by MRI”.1997 : assistant of clinical research in pharmaco-clinical trials (Paris)2009, 2011 : International training for methodology in clinical research

OVIDIU BAJENARU /Romania

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Fields of interest for the scientific research

• dementiaandneurodegenerativediseases(inparticularParkinson’sdisease)• multiplesclerosis• stroke• experimentalandclinicalstudyofsleepdisturbancesintheneurologicalandneuroendocrinologic diseases- more than 450 scientific papers published and reported in different national and international scientific meetings • ISIWebofScience: h-index:8 - 5 medical books and monographies ( published in Romania ) - co-author ( 1 chapter ) to the “International Neurology - A Clinical Approach” ( eds. ROBERT P. LISAK, DANIEL D. TRUONG, WILLIAM CARROLL, ROONGROJ BHIDAYASIRI ), Wiley-Blackwell , 2009- Country Principal Investigator – in more than 20 international, multicentric clinical trials- Principal Investigator of the research site – in more than 30 international and national multicentic trials- Member of the Steering Committee of PRECISE trial

Other activities:

- coordinator of the Continuous Medical Education ( EMC ) national program of the Romanian Society of Neurology for neurologists in Romania - coordinator and author of the Guidelines for diagnosis and treatment of neurological diseases ( agreed by the College of Medecins of Romania )αmain author of the national guidelines for Parkinson’s disease, Multiple Sclerosis and Dementia - coordinator of the National Program of the National House of Insurance and Ministery of Health, for treatment of patients with neurological diseases (2000 - 2015) - coordinator of the first medical team in Romania for DBS in Parkinson’s disease. - chief-editor of Romanian Journal of Neurology ( the official journal of the Romanian Society of Neurology )

Scientific affiliation :• RomanianSocietyofNeurology(HonorayPresidentadvitam)• UEMS–EuropeanBoardofNeurology(SecretaryGeneral–electedin2010)• EuropeanNeurologicalSociety(ENS)–memberoftheExecutiveCommitteebetween2005–2009• EuropeanStrokeOrganization• EuropeanFederationofNeurologicalSocieties(EFNS)andEuropeanAcademyofNeurolgy(since2014)• AmericanAcademyofNeurology(coorespondingmember)• DanubeNeurologicalAssociation(Vice-SecretaryGeneral–electedin2011)• ECTRIMS(memberoftheScientificCouncil2003-2009)• NewYorkAcademyofSciences• AmericanAcademyforAdvancementinScience• MovementDisordersSociety• RomanianAssociationfortheStudyofPain• RomanianSocietyfortheStudyofNeuroplasticity(founderpresidentofhonour)

2005, 2006, 2010, 2011: awarded by the Prize of Excelence in Neurology for the scientific activity in Romania ( decided by a National Jury organized by the Health Chamber of the Romanian Parliament )2008: awarded by the Romanian Society of Internal Medicine for the best scientific activity in a related medical speciality2014: awarded by the International Brain Foundation and Romanian Academy of Medical Sciences, for excel-lency in the development of management of patients with multiple sclerosis in RomaniaInvestigator in an International Program of Research for genetic factors in stroke patients; Country Principal Investigator – in more than 30 international, multicentric clinical trials; Principal Investigator of the research site – in more than 30 international and national multicentic trials

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Graduated in Medicine at the University of Padova Medical School in 1963; Specialist in Neurology in 1967.

During the years 1967-1970 he was Research Fellow at the Institute for Neurochemistry, Columbia University, New York, USA.

Full Professor of Neurology from 1980 and then Director of the Department of Neurosciences of the Medical School of the University of Padova from 1989 to 2009. He is the Scientific Director of the Research Hospital for Neurorehabilitation, IRCCS San Camillo, Venice, from 2005.

He has been member of the Executive Council of the Italian Society of Neurology and the President of the Ital-ian Society for Parkinson’s Disease; he is member of the Executive Committee on Extrapiramidal Disorders and of the one on Dementia of the World Federation of Neurology and Chairman of the Research Group for Organi-zation and Delivery of Neurological Services; he has been Vice-President for Europe of the World Federation of Neurology during the years 2001-2005, and he is the President of the European Society for Clinical Neurophar-macology during the years 2000-2008; he is a member of numerous International Scientific Societies, and Fel-low of the American Academy of Neurology. He is also a member of the Editorial Board of international journals of neuroscience and clinical neurology.

He has organized various International Symposia on specific themes of neuroscience; he was also the President of the 11th World Congress on Parkinson’s Disease that was held for the first time in Italy in 1994.

He has published more than 250 papers in various international and national journals and edited ten volumes on specific arguments of neurology; his main scientific interests have always been cerebral metabolism and func-tion expecially in degenerative diseases of the nervous system, like Parkinson’s and Alzheimer’s disease, as well as in cerebrovascular diseases and in neurorehabilitation.

LEONTINO BATTISTIN/Italy

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EDUCATION:

1965 - 1972 Faculty of Medicine at the University Vienna MD since (promotion on) 1972, June 6th

1972 - 1978 University Hospital for Neurology, graduated in Medical Specialist for Neurology and Psychiatry

9/1982 Docent for neurology, a title corresponding to PhD

since 1988 Professor for Neurology, University Vienna founding member of the Austrian Society for Neurorehabilitation

5/1989 Head of the Neurological Hospital “Maria Theresien-Schlössel”

1994-2007 Head of Ludwig Boltzmann Insitute for Restorative Neurology and NeuromodulationSince 2008 Deputy Head of Landsteiner Institute for Neurorehabilitation and Space Medicinesince 2002 Head of the Neurological Center, Otto Wagner Hospital, Vienna. Main focus: Patients with severe neurological/ neuropsychological deficits and invasive neurorehabilitation methodscurrently President of • AustrianSocietyforNeurorehabilitation(OEGNR)• EuropeanFederationNeuroRehabilitationSocieties(EFNRS)Member of • ManagementCommitteeoftheWorldFederationNeuroRehabilitation(WFNR)• ManagingBoardoftheInternationalDanubeSymposium• EditorialBoardof”JournalofMedicineandLife”:Chairman of • SpecialInterestGroup/WFNR“SpinalCordInjury”• SpecialInterestGroup/WFNR“EarlyRehabilitation”• Scientificpanel/EFNS“BrainrecoveryandRehabilitation”• SpecialBranch/InternationalDanubeSymposium:“NeuroRehabilitation”

Main topic of research: Neurorehabilitation, brain injury, spinal cord injury, vegetative state/ apallic syndrome (more than 140 publications)

HEINRICH BINDER /Austria

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Education:1. Secondary School I. Slavici Arad, Romania2. Medical School: Facultatea de medicina si Farmacie I.M.F. Cluj- Napoca, Romania

Academical qualifications:1. Dr. medic : I.M.F. Cluj Napoca 19812. German acknowledgement as Dr. med. 19873. Specialty qualification: Neurologist 19944. Further specialty qualification: Neurorehabilitationist 2001, Neurophysiologist 2002

Employment:St. Mauritius Therapieklinik Meerbusch since 2002

Professional appointments, scientifical activities:1994-2002 Collaboration with the University of Essen in the field of plasticity after stroke, with an emphasis on the role of theerebellum in motoric learning tasksSince 2002 Collaboration with the University of Düsseldorf in the field of plasticity after stroke2009 Collaboration with the Coma Science Group Liege/Belgium2010 Collaboration with the Neuroradiology of the Wake University Winson- Salem U.S.A. in a study on net-work properties of DOC patients

DANA BOERING/Germany

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Anca Dana Buzoianu, MD, PhD, is Professor of Clinical Pharmacology, Senior Clinical Pharmacologist, Senior Pediatrician, Dean of the Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, President of the Romanian Association of the Medical School’s Deans, General Executive Secretary of the Romanian Society for Pharmacology, Therapeutics and Clinical Toxicology. She is also member of 8 scientific international Societies, and 4 national one.

Postgraduate specialization. Professor Anca Buzoianu is senior clinical pharmacologist and also senior pediatrician. She is the Head of the Department of Pharmacology at Medical Faculty of Cluj, and the leader of a dynamic research team of the department, and member of the Neuroscience Research Center of the Iuliu Hatieganu University of Cluj-Napoca. Professor Anca Buzoianu and her colleagues are actually involved in Pharmacogenetics studies regarding the metabolizing status of some drugs such the oral anticoagulants, antiepileptic drugs, biologic products etc. Other research themes are the therapeutic approach of multiple sclerosis and stroke, pharmacogenetics of the drugs used in dermatological diseases, the effects of some new compounds in pain and inflammation etc. Professor Buzoianu has conducted 8 national grants, 1 international educational project and participated in the research team in another 16 research projects.

Professor Buzoianu has a valuable expertise in Academic Leadership and Management, also in the Management of the Health Care System (Master in the Health Care Management 2009), and in the Quality Assurance evaluation process, being evaluator for the Higher Education for several years. She is President of the Clinical Pharmacology and Toxicology Committee of the Romanian Health Ministry, President of the Pharmacology Committee of the Romanian Physician College, member of the Institutional Evaluation Committee of the Romanian Agency for Quality Assurance in Higher Education.

Scientific and professional societies

• CIDMEF–ConferenceInternationaledeDoyensetdeFacultesdeMedicined’Expresion Francaise - member de Bureau Permanent, • EuropeanAssociationofClinicalPharmacologyandTherapeutics, • InternationalAssociationforMedicalEducation, • InternationalAssociationofMedicalSchool, • TheSocietyfortheStudyofNeuroprotectionandNeuroplasticity • EuropeanCollegeofNeuropsychopharmacology • InternationalAdvisoryBoard-EuropeanSocietyofClinicalNeuropharmacology • BalkanMedicalUnion. • RomanianAssociationoftheMedicalFacultiesDeans-president • GeneralExecutiveSecretaryoftheRomanianSocietyforPharmacology,Therapeuticsand Clinical Toxicology • RomanianAssociationfortheStudyofPain • RomanianSocietyofAddictionandPharmacovigilence,

Scientific activity

•Articlesandstudies-80papersindexedISIandinotherinternationaldatabases •Booksandchapterinbooks-12

ANCA BUZOIANU/Romania

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Prizes Professor Anca Dana Buzoianu has been honored with the “Victor Papilian” prize of the Cluj Medical Faculty in 2006 for her first volume of “Pharmacology” textbook. In 2007 she received the great “Iuliu Hatieganu” Award for her contribution to the development of a novel domain of academic learning in the frame of the Doctoral School.

In 2011 Professor Anca Dana Buzoianu has received the honorary medal of the National Council of the Physicians of the National Order of Doctors de FranceIn 2012 Professor Buzoianu Anca has been honored with the Excellence Award for Academic Management - “Dean of the year” with the occasion of the “Health Gala” - offered by the Romanian Ministry of Education and Health Ministry

In 2013 she won again the great Prize “Iuliu Hatieganu” of the University of Medicine and Pharmacy for her contribution for the obtaining of the quality certificate “Label CIDMEF” by the Medical Faculty of Cluj-Napoca.

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Lăcrămioara Perju-Dumbravă, MD, PhD is Professor of Neurology within the Neurosciences Department, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Chairman of the First Neurology University Clinic, Cluj-Napoca, Romania. Her academic status includes her position as member of the Board of the Faculty of Medicine and of the University’s Senate, as well as Doctorate coordinator in the field of MEDICINE. Her prestigious activity includes: publishing of 3 monographs, co-authorship in other 7 speciality books, 192 scientific papers published in medical journals, chairman and speaker at annual national congresses and conferences, international conferences and membership in editing committees and professional societies, involvement in several clinical studies, her expertise being sought by national medical councils and committees.

LACRAMIOARA PERJU-DUMBRAVA/Romania

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Michael Chopp, PhD, joined the Henry Ford Health System in Detroit in 1983. He was appointed Vice Chairman for Research of the Department of Neurology in 1991, Scientific Director of the Henry Ford Neuroscience Institute in 1999, and is the Zoltan J. Kovacs Chair in Neuroscience Research. Dr. Chopp is also Distinguished Professor of Physics at Oakland University in Rochester, MI.

He received his MS and doctorate degrees in Mathematical and Solid State Physics from New York University. After nearly 10 years of working as a Physicist and as a Professor of Physics, Dr. Chopp made a career change and turned his interest to translational research in neuroscience Dr. Chopp’s research has primarily focused on: 1) cellular and molecular biology of ischemic cell injury, 2) the pathophysiology of stroke, traumatic brain injury, peripheral neuropathy, multiple sclerosis, and glioma, 3) combination thrombolytic and neuro and vascular protective therapies for stroke, 4) mechanisms of neuroprotection, 5) cell-based and pharmacological neuro-restorative therapies for stroke, traumatic brain injury and neurodegenerative disease, 6) molecular and cellular mechanisms underlying neurogenesis and angiogenesis and the induction of brain plasticity leading to functional and behavioral recovery after neural injury, 7) treatment of glioma, 8) exosomes/ microRNA for treatment of neurological injury and disease, and 9) magnetic resonance imaging. Dr. Chopp has over 600 peer reviewed publications and has given 397 plenary lectures and invited presentations. He has chaired National Institutes of Health (NIH) study sections and has often served as a consultant to government agencies, the U.S. National Institutes of Health, and the pharmaceutical industry.

MICHAEL CHOPP/USA

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II. Education: currently working as a neurologist in training (post graduate scholarship)

Institution: State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova, Department of Neurology Date: from(month/year): November, 2012 to (month/year): Ongoing

Degree(s) or Diploma(s): Post graduate studies in neurology (Speciality: Neurologist)Language of the Program: Romanian

Institution: State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova, General Medicine FacultyDate: from(month/year): September, 2006 to (month/year): June, 2012

Degree(s) or Diploma(s): Medical Doctor. Speciality: General Medicine.Final grade at the State examinations: 97.2%.Language of the Program: Romanian

Institution: School no.°62 (currently Lyceum “Minerva”)Date: from(month/year): September, 1995 To (month/year): June, 2006Degree(s) or Diploma(s): Graduation certificate, with grade: 95%Language(s) of subjects: Romanian, English, Russian, German

III. Internships:

30 March- 24 April, 2015. Observership in Neurology. Salzburg, Austria.

July, 2010 Exchange of Experience in Iasi, Romania. Subject matter: Obstetrics, Genecology and Surgery

IV. Language Proficiency:

English excellentRussian, Romanian native speakerGerman beginner level

V. Professional Record:

February, 2010- August, 2014 Medical assistant by plurality of offices at Theoretic Evening Lyceum no.°1, Chisinau Municipality, (Republic of Moldova)

VI. Publications / written works:

2015 2014 Neuromyelitis optica - a case report. Archives of the Balkan Medical Union. 04/2014Chisinau, 49(1): 143-146. ISSN 0041-6940.

DANIELA EFREMOVA/Republic of Moldova

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2014 Modern aspects on the problem of acute pain and strategies for its treatment. Archives of the Balkan Medical Union. 04/2014Chisinau, 49(1):51-56. ISSN 0041-6940.

2012 “Clinical Morphopathological Diagnostics and Treatment Issues of Trophoblast Tumours” (“Scientific Annals of the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova”, Vol. 4, 2012 [Ed. XIII])

2012 “The Algorithm of Application of the Method of Tissue Expansion in Plastic Surgery of Post- Combustion and Post-Traumatic Sequelae” (“Scientific Annals of the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova”, Vol. 4, 2012 [Ed. XIII])

2011 “Bioethical Aspects of Abortion” (“Scientific Annals of the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova”, Vol. 2, 2011 [Ed. XII])

2009 “Ovarian Cancer” (“Scientific Annals of the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova”, Vol. 1, 2009 [Ed. X])

VII. Other diplomas, certificates, distinctions:

2012 Participant’s Diploma at the National Congress of Young Doctors and Students (Bucharest, Romania)

2011 Participant’s Diploma at the Annual University Conference by the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova

2011 Participant’s Diploma at the National Congress of Young Doctors and Students (Bucharest, Romania)

2010 Volunteer’s Certificate. Project by the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova: Healthy Way of Life

2009 Participant’s Diploma at the Annual University Conference by the State University of Medicine and Pharmacy “Nicolae Testemitanu” of the Republic of Moldova

X. Seminars, conferences attended:

28-29 November, 2014. Teaching Course on Movement Disorders. Chisinau, Republic of Moldova.

11-13 June 2014. αst-European Course of Epilepsy - Cheile Gradistei, România.

2-8 March, 2014. Salzburg Weill Cornell Seminar in Neurology. Salzburg, Austria.

September, 2013. Balkan Medical Union’s Congress Chisinau, Republic of Moldova.

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1987-1991 : Neurologist at the Republican Clinical Hospital, Chisinau

1991-1996 : Assistant professor of the Department of Neurology and Neurosurgery at the State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau

1996-2001 : Docent of the Department of Neurology and Neurosurgery at the State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau

2001-2010 : Deputy Director of the Institute of Neurology and Neurosurgery, Chisinau

2010 (since) : Professor of Neurology, Chairman of the Neurology Department at the State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau

2010-2012 : Dean of the Faculty of Medicine 2 - State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau

2012 (since) : Vice-rector for International Relations - State University of Medicine and Pharmacy “Nicolae Testemitanu” Chisinau

Fields of special interests: ischemic tolerance of the nervous system, vascular cerebral and spinal cord diseases, and encephalitis.

MIHAIL GAVRILIUC /Republic of Moldova

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EducationSeptember 1, 1988 – June 24, 1994 Dnipropetrovs’k Medical Institute c. Dnipropetrovs’k, Ukraine.Medical Doctor, Honors Diploma, Specialty- general medicine.

Residency:August 1, 1994 – June 28, 1996 Dnipropetrovs’k State Medical Academy, Neurology & Neurosurgery Department,Dnipropetrovs’k, Ukraine.Doctor – specialist, Specialty – neurology

Clinical fellowship:September 1, 1996 – August 31, 1998Dnipropetrovs’k State Medical Academy, Neurology & Neurosurgery Department, Dnipropetrovs’k,Ukraine.Cerebrovascular neurology

PhD program – NeurologyApril 1999-May 2003,Kharkiv Medical Academy of Postgraduate educationPh.D., Speciality – Neurology

Internship – Neurology (Alberto Vilar Internship)March 02-24, 2004Christian Doppler Landeskliniken Neurology, Salzburg, Austria

Training – Expert Spasticity Management training courseJuly 19-20, 2010,University Hospital of North Staffordshire, North Staffordshire Rehabilitation Centre,Stoke on Trent, UK

Training – Update on Management of Vertigo and Vestibular DisordersMay 19-20, 2011University of Provence, Marseille, France

Training – Vestibular Disorders and Vertigo Treatment MasterclassJune 16, 2012Maastricht University Medical Centre, Maastricht, Netherlands

Publications 210 scientific publications

Professional AffiliationMember,European Neurological Society (1999),Movement Disorders Society (2007)Ukrainian Anti-Stroke Association (2007),Regional Society of Clinical Neurology, Dnipropetrovs’k Region, Ukraine.

VOLODYMYR GOLYK/Ukraine

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Carrier formation

Since 2008 Full professor of Neurology, University Hospital Essen, Germany2011 Geriatrics board, Bezirksärztekammer Nordrhein2008 Pain therapy board, Bezirksärztekammer Nordrhein2002-2007 Associate professor, Department of Neurology, University Hospital Zurich, Switzerland (Prof. Dr. C. Bassetti) 2007 Sleep medicine board, Bezirksärztekammer Südwürttemberg2002 State doctorate, University of Tübingen, Germany2001 Neurology board, Bezirksärztekammer Südwürttemberg1998-2001 Resident, Department of Neurology, University of Tübingen, Germany (Prof. Dr. J. Dichgans)1995-1998 Research associate, Max Planck Institute (MPI) for Neurological Research, Cologne, Germany (Prof. Dr. K.-A. Hossmann)1995 Approbation” (medical licensure)1995 M.D. University of Gießen, Germany: ‘Afferent and efferent projections of raphe magnus and pallidus nuclei’ at Physiological Institute, University of Gießen, Germany1994-1995 “Arzt im Praktikum”/ resident, Max-Planck-Institute of Psychiatry, Munich, Germany (Prof. Dr. Dr. F. Holsboer)1993 Practical year1990/1991 MD thesis studies Department of Expt. Medicine, Lyon, France (Prof. Dr. M. Jouvet)since 1990 Fellow of “Studienstiftung des Deutschen Volkes”1987-1994 Studies of Human Medicine at University of Gießen, Germany1987 “Abitur” (German high school diploma: Grade 1,0)1980-1987 High School: Justus-Liebig-Schule Gießen, Germany 1974-1980 Elementary School: Ludwig-Uhland-Schule Gießen, Germany

DIRK M. HERMANN/Germany

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Wolf-Dieter Heiss, born 31.12.1939 in Zell am See, Austria, graduated in medicine from the University of Vienna, Austria, in 1965. He achieved his training in neurology, neurophysiology, psychiatry and nuclear medicine at the University hospital in Vienna and spent research fellowships at the MIT, Cambridge, USA, the Physiological Institute in Stockholm, Sweden, the Department of Physiology of SUNY, Buffalo, NY and the Department of Neurology of the University of Minnesota, Minneapolis, USA. 1976 he was appointed associate professor at the Department of Neurology of the University of Vienna. In 1978 he became director of the Center for Cerebrovascular Research of the Max Planck Institute for Brain Research and of the Department of Neurology of the City Hospital Cologne-Merheim, Germany. 1981 he was appointed as director at the Max Planck Institute for Neurological Research. 1985 – 2005 he was professor of neurology and chairman of the Department of Neurology of the University of Cologne and director of the Department of General Neurology at the MPI in Cologne. He was president of the International Stroke Society 1992-96, was on the board of directors of the Society for Cerebral Blood Flow and Metabolism, deputy editor of the Journal of Cerebral Blood Flow and Metabolism and at present is associate editor of the Journal of Nuclear Medicine and section editor of Stroke. He was chairman of the program committee of the European Federation of Neurological Societies (EFNS) 1998 - 2001 and was president of the EFNS 2001 – 2005. Since 2005 he is Visiting Professor at the Danube University in Krems, Austria, and since 2009 Adjunct Professor at the McGill University in Montreal, Canada.

His significant portfolio of scientific articles includes 617 papers indexed on Web of Knowledge-ISI, rating a Hirsch index of 63.

In 2013 he became Associated Professor of the Department of Neurosciences, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Romania.

WOLF DIETER HEISS/Austria

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MEDICAL DIRECTOR St. Mauritius Therapy Hospital Meerbusch

PERSONAL DATA Born 25 July 1954 Married to Priv.-Doz. Dr. Kristina Müller, paediatric neurologist

MEDICAL CAREER

1973 - 1980 School, Universities of Düsseldorf and Freiburg; Elective in Neurology at Boston City Hospital, Boston, Mass.; National Hospital for Nervous Diseases, Londonsince 1975 Junior researcher in the Department of Neuropsychology at the C. & O. Vogt Institute for Brain Research, Düsseldorf and the Department of Neurology, Freiburg (Prof. R. Jung)1980 - 1981 Research fellow in the Department of Neuropsychology (Prof. G. Grünewald) at the C. & O. Vogt Institute for Brain Research, Düsseldorfsince 1981 Clinical training in the Department of Neurology (Prof. H.-J. Freund), Heinrich- Heine-University Düsseldorfsince 1985 Senior registrar in the Department of Neurology, Heinrich-Heine- University Düsseldorfsince 1987 Senior investigator for the German Research Council Special Task Force in Neurology at Heinrich-Heine-University (SFB 200 and SFB 194)1987-2005 Medical director of the Neurological Therapy Center (NTC), Heinrich-Heine-University Düsseldorfsince 1988 Board examiner for Neurology at the local examination board (Ärztekammer Nordrhein)1989-1997 Vice president of the German Society for Neurological Rehabilitation1993 Habilitation in Neurology, Heinrich-Heine-University Düsseldorfsince 1995 Board examiner for physical medicine and rehabilitation (Ärztekammer Nordrhein)1997-2005 Medical director of the Neurological Therapy Center, Cologne1998-2004 President of the German Society for Neurological Rehabilitationsince 2000 Medical director and head of neurology, St. Mauritius Therapy Hospital, Meerbuschsince 2003 Secretary General World Federation for NeuroRehabilitation (WFNR)since 10/2004 Vice president of the German Society for Neurological Rehabilitationsince 2005 Panel-Chairman Neurorehabilitation for European Federation Neurological Societies (EFNS)

VOLKER HÖMBERG/Germany

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Date of Birth: 6th July 1946

Place of Birth: Gravesend, Kent

Education:

1956-1964 Gravesend Grammar School 1964-1972 Chelsea College, University of London Degrees and Diplomas:

1964-1967: B. Pharm(Hons) 2:1, Chelsea College, University of London1967-1970: Ph.D., Chelsea College, University of London1972: Membership of the Royal Pharmaceutical Society of Great Britain1987: D.Sc., University of London1994: Fellow of the Royal Pharmaceutical Society of Great Britain2005: Fellow of the British Pharmacological Society2006: Fellow of King’s College London 2008: Emeritus Professor of Pharmacology, King’s College London2011: Fellow of the Royal Society of Medicine

Honours and Achievements:

- Elected Fellow of the British Pharmacological Society - Elected Fellow of King’s College London- ISI Most Cited Author in Neuroscience – Ranked in top 0.5% of all neuroscience authors in the world- Scientific Impact – Hirsch Index 72 (Admission to National Academy of Sciences USA average 52)- Winner THES Spinout of the Year 2005 – National Award for the most successful company formed in academia- Rated in Top Ten Entrepreneurial Academics in the UK – THES/Independent- National Parkinson’s Foundation Centre of Excellence for ‘gold standard’ research excellence in Parkinson’s disease 2005- International Movement Disorder Society – Extraordinary Contribution to Movement Disorders (Honorary Membership)

Appointments:

1970-1972 Postdoctoral Fellow in the Department of Pharmacy, Chelsea College, University of London 1972-1978 Lecturer in Biochemistry, University Department of Neurology, Institute of Psychiatry1978-1985 Senior Lecturer in the above Department1983-1985 Honorary Senior Lecturer, King’s College Hospital Medical School1985-1989 Reader in Neurochemical Pharmacology, University Department of Neurology, Institute of Psychiatry and King’s College Hospital

PETER JENNER/UK

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Medical School

1988-2000 Honorary Senior Lecturer, Institute of Neurology1989-1998 Professor of Pharmacology and Head of Department, King’s College London1993- Director, Neurodegenerative Diseases Research Centre, King’s College London1998-2004 Head of Division of Pharmacology and Therapeutics, Guy’s, King’s and St. Thomas’ School of Biomedical Sciences, King’s College London2005 Professor of Pharmacology, Guy’s, King’s and St. Thomas’ School of Biomedical Sciences, King’s College London2005-2010 Director of Proximagen Ltd2008 Emeritus Professor of Pharmacology, King’s College London

Editorial Boards:

Journal of Pharmacy and PharmacologyPolish Journal of PharmacologyJournal of Neural Transmission (Handling Editor) Neuropharmacology (Handling Editor 2002 - )Synapse (European Editor 1990 - )International Review of Neurobiology (Series Editor)

Past Activities:

Director, Parkinson’s Disease Society Experimental Research Laboratories (1988-1999) Elected Member of Council, Parkinson’s Disease Society (1993-1999)Member of Medical Advisory Panel, Parkinson’s Disease Society (1993-1999)Member of Biochemical Society - Molecular and Cellular Pharmacology Group Committee (until 2000)President of Watford Branch of Parkinson’s Disease Society 2000Secretary of Basal Ganglia ClubMember of Board of Management, Institute of Epileptology, King’s College LondonMember of Medical Advisory Board of Bachman-Strauss Foundation, New York 2000-2005Journal of Neurochemistry (Handling Editor 1998-2008)Vice-President of European Society for Clinical Pharmacology 2001-2008

Current Activities:Consultant to the Pharmaceutical Industry

Referee for research grant applications from:

Royal Pharmaceutical SocietyMedical Research CouncilWellcome TrustParkinson’s Disease SocietyINSERM, France

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Professor Korczyn graduated from the Hebrew University – Hadassah Medical School in Jerusalem in 1966 (MD), where he also received an MSc degree in pharmacology (cum laude) in 1966. He trained in neurology at Beilinson Hospital and at the National Hospital for Nervous Diseases, Queen Square, London. He was the Chairman of the Department of Neurology at the Tel-Aviv Medical Center since 1981 until 2002, and the incumbent of the Sieratzki Chair of Neurology at Tel-Aviv University, 1995-2010. Professor Korczyn has a particular interest in neurodegenerative diseases. He has authored or co-authored over 600 articles in peer-reviewed journals, as well as chapters in books, etc. He edited several books and Special Issues in Journals, and is co-Editor of the Journal of the Israeli Neurological Association (JINA) since 2009. He is or has been an Editorial Board member of 20 international journals, and organized several neurological conferences, mainly in the field of dementia, Parkinson’s disease and other degenerative brain disorders, as well as CONy – the International Congress on Controversies in Neurology. Professor Korczyn also served on advisory boards in several drug discovery programs.

Professor Korczyn is the Chairman of the Scientific Administrative Board of the Israeli Alzheimer’s disease association (EMDA), and member of the SAB of Alzheimer Disease International, and has been the chairman of the WFN Research Committee for Neuropharmacology.

Professor Korczyn is an honorary member of the neurological societies of Israel, Serbia, Poland and Russia.

Professor Korczyn’s H-index is 39.

AMOS KORCZYN /Israel

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Dr. Vitalie Lisnic is a Professor of Neurology at Department of Neurology of the State University of Medicine and Pharmacy „Nicolae Testemitanu”, Chisinau, Republic of Moldova. He is a consultant in the Department of Vertebroneurology and Neuropathies, responsible for electromyographic examinations at the Institute of Neu-rology and Neurosurgery in Chisinau.

Dr. Lisnic graduated the Faculty of General Medicine of the Chisinau State Medical Institute in 1989. He passed internships in Neurology and Neurophysiology in Moscow (Russian Federation) in 1993, Charles University, Pilsen (Czech Republic) in 1994, Landesnervenklinik of Salzburg (Austria) in 1999, Emory University, Atlanta (USA) in 2002 and 2003, Vienna University (Austria) in 2008. In 2003 obtained a clinical attachment in neu-ropathies at the National Institute of Neurology, Queen’s Square, London, UK. In 2003-2004 he was the Prin-cipal Investigator of the Moldovan team of the grant of the Moldovan Research and Development Association and U.S. Civilian Research and Development Foundation.

Dr. Lisnic other important responsibilities include the following:• PresidentoftheMoldovanNeurologicalAssociation• MemberoftheEducationCommitteeoftheEuropeanAcademyofNeurology• DelegateoftheRepublicofMoldovainWorldFederationofNeurologyand European Academy of Neurology• MemberoftheAmericanAcademyofNeurology• MemberofMovementDisordersSociety• Memberofeditorialboardof2MoldovanandoneUkrainianmedicaljournals

Dr. Vitalie Lisnic is the author of more than 150 scientific publications in Moldovan and International biomedical journals. Under his guidance were defended 4 Ph.D theses.

VITALIE LISNIC/Republic of Moldova

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Professional Experience: 1979 - 1984 Resident, Board Neurology and Psychiatry (Department of Neurology and Psychiatry, University of Münster FRG) (Prof. G. Brune, Prof. R. Tölle)1984 - 1985 Stipend, Deutsche Forschungsgemeinschaft: Institute of Neurotoxicology, Albert Einstein College of Medicine, Bronx, New York (Prof. P.S. Spencer, Prof. H.H. Schaumburg)1985 - 1989 Staff, Department of Neurology, University of Münster (Prof. G. Brune)1987 Habilitation, Faculty of Medicine, University of Münster, C2 Professor of Neurology1990 - 1992 Staff Scientist, Visiting Assoc. Prof., Center for Research on Occupational and Environmental Toxicology, Portland (Oregon)1992 Staff, Department of Epileptology, University of Bonn (Prof. C.E. Elger)1993 - 1996 C3 Professor of Neurology, Vice Chairman, Department of Neurology, Humboldt University Berlin (Prof. K.-M. Einhäupl)1996 C4 Professor of Neurology, Chair, Department of Neurology, University of Ulm2003 - Chair (elected) Academic Neuroscience Center, University of Ulm2005 – 2009 Deputy Chair and Chair (elected), European ALS-MND-Group2008 - Chair, Scientific Council of Deutsche Stiftung Querschnittlähmung (DSQ)2008 - 2012 Chair Scientific Council Deutsche Gesellschaft für Muskelkranke2009 – Chair (elected), World Federation of Neurology, ALS Research Group2009 – Member of the Fachkollegium Neurowissenschaften der deutschen Forschungsgemeinschft (DFG) (elected)2010 – Vice Dean oft the Medical Faculty oft the University of Ulm2014 - Board, Scientific Board Stifterverband für die Wissenschaften Chair (reelected), World Federation of Neurology ALS Research Group 2014 - Delegate of the German Society of Neurology to the World Federation of Neurology

ALBERT LUDOLPH /Germany

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Tudor Lupescu obtained his medical degree from “Carol Davila” University of Medicine in Bucharest, in 1989. After 3 years of training at Colentina Clinical Hospital he became Specialist in Neurology in 1994. Since 2006 he is running the Neurology Department al Agrippa Ionescu Hospital in Bucharest. 1998, he qualified as Consultant Neurologist. Since his early years of training in Neurology, Tudor Lupescu has shown a special interest in Clinical Neurophysiology. In 2000 he earned a Competence in Clinical Neurophysiology (EEG, EMG, and Evoked Poten-tials). 1997 he was the first to use Transcranial Magnetic Stimulation in Romania. This was also the subject of his PhD thesis presented in 2005. Since 2008, Tudor Lupescu is President of ASNER – Romanian Society of Electrodiagnostic Neurophysiology. He is also founding member and vicepresident of the the Romanian Society of Diabetic Neuropathy.

Dr Tudor Lupescu is associate member of the American Academy of Neurology, and associate member of the American Association of Neuromuscular and Electrodiagnostic Medicine. Between 2008 and 2013 he was also member of the Neurophysiology Subcommittee of ENS.

TUDOR LUPESCU /Romania

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Ion Vasile Moldovanu, Republic of Moldova (RM) citizen, MD, PhD., Professor of Neurology, specialist in chronic pain (especially primary and secondary headaches), autonomic nervous system and movement disorders. He holds a PhD-1 and PhD-2 thesis in Neurology from Medical Institute “I. M. Secenov”, Moscow (Russia) in 1983 and 1991 respectively. He became Professor in 1996.

For many years professor Moldovanu develops the concept of the Functional Neurology using different models of functional and organic neurological pathologies. Currently he is concerned with the study of the phenom-enon of consciousness and altered states of consciousness (in collaboration with specialists in the field of physiology, biophysics and quantum physics) in order to develop a novel therapeutic non-pharmacological ap-proach by means of neurostimulation techniques.

Professor Ion Moldovanu is currently working in the Neurology Department of Medical and Pharmaceutical Uni-versity “Nicolae Testemitanu” of the Republic of Moldova and in the Institute of Neurology and Neurosurgery as senior researcher.

Academic positions: Director of the Institute of Neurology and Neurosurgery (2009-2013). Head of the Department of Neurology of Medical and Pharmaceutical University “Nicolae Testemitanu” of the Republic of Moldova (1998-2009).Researcher at the Neurology department of the Moscow Medical Institute “I. M. Secenov” in Russia (1983-1991). He founded and is actually President of the Society of Headache and Pain of the RM, vice President of Neuro-logical Society of the RM, honorary member of the French Society of Neurology, the founder and President of the Association of Psychoanalysis and Psychosomatic in Moldova.

International cooperation: scientifically research program in movement disorders at the Premontre Hospital (France) in connection with Salpetriere Clinic (Paris, France) – 1991-1993, visiting Professor at the University “Joseph Fourier” (Grenoble, France, 1996), at the Institute of Neuroscience from the Paris VI University (Paris, France, 1997), Fulbright clinical and scientifically research Program in the Mayo Clinic Headache Center (Scott-sdale, Arizona, USA, 2002-2003), practical clinical training in the Headache Emergency Center of the Lariboi-siere Hospital (Paris, France, 2006), etc.He was responsible for many international projects, as the Epidemiology of primary headaches in the RM sup-ported and guided by the International Headache Society (2005), the Non-pharmacological treatment of acute and chronic headaches by transcranial electrical stimulation (BMBF project Moldova-Germany 2010-2011, bi-lateral Moldovan-Ukrainian-European project 2007-2010).

Author of about 350 scientific papers, co-author of 2 books, 3 monographs, 1 compendium, 3 patents, scien-tific coordinator of the International Classification of Headache Disorders translation from English into Roma-nian (2004, 2015). He trained 12 doctors in medical science and is currently leading 9 MD thesis in progress.

For many years professor Ion Moldovanu was a member of the board of the International Headache Society and European Headache Federation.

ION VASILE MOLDOVANU/Republic of Moldova

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Professor of Neurology, Senior Neurologist, Chairman of the Neurosciences Department, Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, President of the Romanian Society of Neurology, President of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), member of the Academy of Medical Sciences, Romania, secretary of its Cluj Branch. He is also member of 13 scientific international societies (being member of the American Neurological Association (ANA) - Fellow of ANA (FANA) since 2012) and 7 national ones, being part of the executive board of most. Professor Dafin F. Muresanu is a specialist in Leadership and Management of Research and Health Care Systems (specialization in Management and Leadership, Arthur Anderson Institute, Illinois, USA, 1998 and several international courses and training stages in Neurology, research, management and leadership). Professor Dafin F. Muresanu is coordinator in international educational programs of European Master (i.e. European Master in Stroke Medicine, University of Krems), organizer and co-organizer of many educational projects: European and international schools and courses (International School of Neurology, European Stroke Organisation summer School, Danubian Neurological Society Teaching Courses, Seminars - Department of Neurosciences, European Teaching Courses on Neurorehabilitation) and scientific events: congresses, conferences, symposia (International Congresses of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), International Association of Neurorestoratology (IANR) & Global College for Neuroprotection and Neuroregeneration (GCNN) Conferences, Vascular Dementia Congresses (VaD), World Congresses on Controversies in Neurology (CONy), Danube Society Neurology Congresses, World Academy for Multidisciplinary Neurotraumatolgy (AMN) Congresses, Congresses of European Society for Clinical Neuropharmacology, European Congresses of Neurorehabilitation). His activity includes involvement in many national and international clinical studies and research projects, over 200 scientific participations in the last 7 years as “invited speaker” in national and international scientific events, a significant portfolio of scientific articles (113 papers indexed on Web of Science-ISI, H-index: 14) as well as contributions in monographs and books published by prestigious international publishing houses. Prof. Dr. Dafin F. Muresanu has been honoured with: the Academy of Romanian Scientists, “Carol Davila Award for Medical Sciences / 2011”, for the contribution to the Neurosurgery book “Tratat de Neurochirurgie” (vol.2), Editura Medicala, Bucuresti, 2011; the Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca “Octavian Fodor Award” for the best scientific activity of the year 2010 and the 2009 Romanian Academy of Medical Sciences “Gheorghe Marinescu Award” for advanced contributions in Neuroprotection and Neuroplasticity.

DAFIN F. MUREŞANU/Romania

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Current position- Professor in Physical Medicine, Rehabilitation and Balneoclimatology at the University of Medicine “Carol Davila”, Bucharest- Head of Rehabilitation Department - University of Medicine “Carol Davila”, Bucharest - PhD- Chief of University Rehabilitation Department III – National Institute of Rehabilitation, Physical Medicine and Balneoclimatology- European Board certified in PRM- EFIC Councilor for Romania- Senior consultant in Physical Medicine and Rehabilitation

Medical Career1978 – MD at the Faculty of Medicine – University of Medicine “Carol Davila”, Bucharest 1982 – University assistant and resident doctor – Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine “Carol Davila”, Bucharest 1985 – Specialist in Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine “Carol Davila”, Bucharest, confirmed by the Ministery of Health of Romania1992 – Lecturer – Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine “Carol Davila”, Bucharest1997 – PhD at the University of Medicine “Carol Davila”, Bucharest1998 – Ass. Professor of Balneoclimatology, Sport Medicine and Physical Medicine – University of Medicine “Carol Davila”, Bucharest 2002 – 2004 – Medical Director of National Institute of Rehabilitation, Physical Medicine, Balneoclimatology, Bucharest, Romania2003 – Professor of Rehabilitation, Physical Medicine and Balneoclimatology

Post-graduated training and fields of interest in scientific research1. ICF Workshop –Oct. 2011, Notvill, Switzerland2. Speaker at the Neuro-rehabilitation School of SSNN-from 20123. Musculoskeletal Ultrasound Course, October 10-12, 2008, Bucharest4. Project “Postgraduate Training in Romania; Competence in Public Health Administration and Management”, Bucharest, 22.06.20075. “4th Symposium - Discussion Platform for Pain, Surgery and Rehabilitation Aspects”, Bodrum, Turkey, 30.04-3.05.2007 6. “ISCD Bone Densitometry Course & Workshop”, Bucharest, March 1-3, 20077. “Project Management in Clinical Research”, Wien, February 19-21, 20078. “Introduction to Good Clinical Practice”, Wien, December 12-13, 2006 9. “ EMG Course”, “UMF Carol Davila”, Bucharest, 200610. “Research in Robotics Technology and Virtual Reality Applyed in Physiotherapy”, Bucharest, October 3, 200611. “Hospital Management”, Bucharest, September 18.- November 17, 2006 12. The Second International Course for Hand Surgery and Hand Therapy”, Cluj-Napoca, September 22-24, 200613. “35th Congress of the International Society of Medical Hydrology and Climatology”, Istanbul Turkey, June 6-10, 200614. External Auditory Course - Sistem of Quality Management SR EN ISO 9001/2001, SR EN ISO 19011/2003”, Bucharest – SIMTEX, february 6-10 200615. “The First International Course for Hand Surgery and Hand Therapy”, Cluj-Napoca, September 23-25 , 200516. “Electrostimulation of the innervated and denervated skeletal muscle”, during the 14th European Congress of Physical and Rehabilitation Medecine, Wien, Austria, May 12-15, 200417. ”Management of Educational Project”, Ministry of Health– CNPPMFA, June 9-13, 2003

ADRIANA SARAH NICA/Romania

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18. “Training Trainers and Evaluators for Testing and Checking Laboratories”, 16-20 June 2003 – Certificate of Training RENAR19. ERASMUS Program – “Actualities in Biomecanic and Gate Analysis”, European School Marseille, France, June 1-11 200320. “4th Congress of Hand Surgery”, “5th National Congress of Reconstructive Micro Surgery”, 15-16.10.2002, Bucharest21. “International Workshop for Hand Rehabilitation”, Bucharest, 15-16 .10.2002 22. “Course of General Echography”, Competence in Ecography, UMF Carol Davila, June 28, 2002, Bucuresti 23. “Course for Training Trainers” – Diploma of Instructor Trainer in Rehabilitation, Physical Medicine and Balneoclimatology , Ministry of Health, May 200224. “5th ESRA WORKSHOP “NEURAL BLOCKADES ON CADAVERS” – Institute of Anatomy, University of Innsbruck / Austria, February 21-23, 200225. ,, Electromyography Testing, Evoked Potentials and EEG”, UMF ,,Carol Davila”, March 6-31, 200126. Competence in Pain Therapy”- National Institute for Traing of Pyisicians and Pharmacists, 4.12.200127. ,,Paliative Medicine – An Compulsory Part of Today’s Medicine” -International Course of Romanian Society of Paliative Medicine and Tanatology”, Sinaia, oct 28-30, 199928. Building a Strong Foundation in Medical Rehabilitation, May 31–June 2, 1999, CARF – The Rehab. Accreditation Commission LUND, Sweden29. Competence in Biostimulation of Laser Therapy30. Competence in Pain Therapy31. « Reeducation Fonctionelle » Postgraduate training in Rehab, December 1991 – March 1992, Secretariat d’Etat Aux Handicapes et Accidentes de la Vie, Nancy, France32. “New Priorities for Health Care”– Management in Heath Sciences, Salzburg, June 199133. “Homeopathy” (1986-1988), “Acupuncture” (1983)

Scientific activityAuthor of 4 booksChapters in published books - 9 chapters Author or coauthor of more than 200 papers published in national and international issuesResearch: project manager in 6 national projects, partner in 1 international projectKeynote speaker in international congresses and conferences: Verona (1995), Florence (2008), Bucharest (2007, 2008)Delegate of ISPRM WRD Commitee for ICF, 2011

Affiliation- Romanian Association of Physical Medicine and Rehabilitation ISPRM (International Society of Physical & Rehabilitation Medicine (Board member since 2010)- Romanian Association for the Study of Pain (Past President) - Romanian Rheumatological Association- Romanian Association for Osteoporosis- Romanian Association for Laser- Romanian Association for Psycho-neuro-endocrinology- Romanian Association for Geriatry- I.A.S.P. - Fellow of Seminar Salzburg Society- EFIC (Councellar of the Board of European Federation International Corner Committee for Romania – 2006 - 2012)- Romanian Termography Medical Association (President)- Member of the PRM Commision in the Ministry of Health

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Education: Oct 1974 – June 1980 UMF “Iuliu Haţieganu”-Cluj, General practitioner 1982 – prezent UMF “Iuliu Haţieganu”-Cluj, Project Manager, physician on rehabilitation, physi-cal medicine, balneology

Degree : Doctor of Medicine Degree, Project Manager

Working experience: 24 years

1982 – present Chair of Balneophysical Therapy and Medical Rehabilitation, UMF “Iuliu Haţieganu”-Cluj, Lecturer 1982 – present Rehabilitation and Physical Medicine department, Clinical Rehabilitation Hospital, Head of Department

Present working status and position: Clinical Rehabilitation Hospital, General Director, Head of Department

Experience in medical field : 22 years;

Elaborated and/ or published research: most important projects:5 scientific projects: VIASAN, project participant, no. 128/2004

BOOKS, MONOGRAPHIES1.Alexandrina Nicu, I. Onac, Luminiţa Pop, Rodica Ungur, Laszlo Irsay, Liviu Pop/ sub redacţia Conf. Dr. Liviu Pop: Evaluare clinică articulară şi musculară, University Medical Publishing House „Iuliu Haţieganu” – Cluj, 2002.173 pages, B5 format, ISBN 973-8385-39-32.L. Irsay, L. Pop: Masajul medical clasic, suport DVD, ISBN 973-693-127-7, DACIN SARA 1060/2005, University Medical Publishing House „Iuliu Haţieganu” – Cluj, 20053.I.Onac: Masajul medical, University Medical Publishing House „Iuliu Hatieganu” Cluj-Napoca, 2009.13. Member of profesional associations: Romanian Society of Physical and Rehabilitation Medi-cine, European Society of Physical and Rehabilitation Medicine .14. Language knowledge: english, french.15. Other core copetences:16. Specialisation and qualification: physician, rehabilitation, physical medicine, balneology17. Cumulated experience other national/international programmes: Active grants:1.PN-II-ID-PCE-2008-2 Grant, no.ID- 2623 /2008Studiul efectelor ultrasonoterapiei asupra balantei oxidanti/antioxidanti la pacientii artroziciRole : Member

Past grants:1.VIASAN Grant no.362/2004,2005-2006: Eficientizarea tratamentului artrozelor prin demonstrarea utilitatii condroprotectoarelor pe plan clinico-functional, biologic si radiologic Role: Member2.CNCSIS Grant no. 1415/2006, 2006-2008: Ameliorarea calitatii vietii femeilor cu osteoporoza prin asocierea la medicatia osteoporotica a metodelor balneofizioterapeutice si a unor practici de management, marketing social Role:Member

IOAN ONAC/Romania

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Dr. Gelu Onose - 58 years (born: the 20th of December,1956); graduated, in 1982, from the Faculty of General Medicine, within the Institute of Medicine and Pharmacy, in Bucharest, Romania - Professor at the (State) University of Medicine and Pharmacy (UMP) “Carol Davila”, in Bucharest

- Doctoral/ Post-Graduate Tutor - at the (State) University of Medicine and Pharmacy ”Carol Davila” (UMPCD), in Bucharest

- MD; - PhD; - MSc

- Senior Physician of : - Physical & Rehabilitation Medicine (PRM) and - Gerontology & Geriatrics (G-G) Competences in : - General Ultrasonograpy - Management of sanitary services

- Chief of the of the UMPCD PRM Discipline and of the P(neural-muscular)RM Clinic Division - the National Reference Center for NeuroRehabilitation - and of its RDI Nucleus, at theTeaching Emergency Hospital“Bagdasar-Arseni” (TEHBA), in Bucharest

- President Co-Founder of the Romanian Society for Neurorehabilitation (RoSNeRa) - affiliated to the World Federation for NeuroRehabilitation (WFNR) - member of the Management Committee - and respectively, of the Romanian Society for Spinal Cord Pathology, Therapy and Rehabilitation (RoSCoS) - affiliated to the International Spinal Cord Society (ISCoS) and to European Spinal Cord Injury Federation (ESCIF)

- A member of the Scientific Committee – proposed Co-ordinator for SCI researches (2014) – afferent to the Prezidium of the world Academy for Multidisciplinary Neurotraumatology (AMN)

- Selected and invited - as among ”Highly-specialized scholars” - by Thomson Reuters to participate in the invitation-only ”Academic Reputation Survey”, within its related partnership with Times Higher Education’s influential World University Rankings: 2010, 2011, 2012

- Invitated Peer-Reviewer (March 2010) by the “Journal of Molecular Histology” and (March, 2012) by the ”Spinal Cord” journal (both ISI Thomson Reuters rated)

- Contributing member/ (2011-2012) to the achievement of the imposing educational project: ”E-Learning for Spinal Cord Injury Health Professionals”, of the International Spinal Cord society (ISCoS) - including/ specifically, în 4 modules/ submodules of it: (Clinical Assessment of Patients with SCI; Assistive Technology Module and Mobility & seating sub-module; Management of neurogenic bladder; Physiotherapy Module and Physical therapy perspectives on rehabilitation sub-module - Gest Editor within its Special Issues: Second Edition, Vol. 4, 2011 and Vol. V, Third Edition, 2012

- Founder Member of the Honorary Editorial Board of the Journal of Neurorestoratology (since 2013)

- Senior Expert (since 2012) within, and Chairman (since 2013), of the Active and Healthy Ageing - Working Group (WG), and also Rapporteur (since 2013) on Chronic Conditions Management of the Comité Permanent/ Standing Committee of the European Doctors (CPME)

- Invited lecturer to all – since the first – European Teaching Courses on Neuro-Rehabilitation, with training conference presentations (in 2011, 2013, 2015) and to the organization (in 2012), contributions

GELU ONOSE/Romania

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- Invited Professor to deliver two extended lectures to the Symposium: ”BEYOND TBI (Optimizing Management in TBIs)”, held in August, 2013, in Mumbai, India, within an International Educational Program of McCann-Erickson Healthcare Complete Medical

- 8 published medical books - one of them : “The Spondyloarthropathies” received, in 2002, the “Iuliu Hatieganu” Award of The Romanian Academy)

- 4 chapters within medical books

- Over 200 scientific works, papers – communicated within national and international scientific meetings and/or published in peer-reviewed or non peer-reviewed medical journals – and professional interviews/ articles, in mass-media - 3 Patents/ Invention Certificates (plus 2 Utility Models), appointed by the State Office for Inventions and Marks (SOIM/ OSIM)

- Main awards: the “Iuliu Hatieganu” Award of The Romanian Academy (2002); the Award of the (Romanian) National Authority for Scientific Research for the RDI project acronymed ”ACTUAT” (2006); the Gold Medal at the International Saloon of Inventions, Geneve/ Switzerland for the RDI project acronymed ”MOD” (2008)

- A member of the Scientific Council/ Editorial Board of medical journals: - ”Journal of Medicine and Life” (rated in Index Medicus, Medline) - “Infomedica” - (Romanian) “Rehabilitation, Physical Medicine and Balneology“ - “Romanian Neurosurgery” - ”Industria Textila” (ISI Thomson rated journal) - Founder Member of the Honorary Editorial Board of the ”Journal of Neurorestoratology”

- A member of the (scientific societies): - Romanian Medical Association (RMA) - Romanian Society of Physical and Rehabilitation Medicine (PRM) - Including of its Board - Romanian Society of Neurosurgery (RSN) - Romanian Society of Biomaterials (RSB)

- Balkan Medical Union (BMU), - International Society of Hydrothermal Technique (SITH - the National Council of the Romanian Section SITH - RS) - British Society of Gerontology (BSG) - International Spinal Cord Society (ISCoS) - European Spinal Cord Injury Federation (ESCIF) - World Academy for Multidisciplinary Neurotraumatology (AMN) - World Federation For Neurorehabiliation (WFNR) - a member of the Council/ Management Committee - International Society of Physical and Rehabilitation Medicine (ISPRM)

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Cristian Falup-Pecurariu received his medical degree from the University of Medicine and Pharmacy “Iuliu Haţieganu” from Cluj-Napoca. He hold a 1 year fellowship of the European Neurological Society in movement disorders and sleep medicine at Hospital Clinic, University of Barcelona, Spain.

He is Head of the Department of Neurology, County Emergency Clinic Hospital from Brasov, and is Lecturer of Neurology at the Transilvania University from Braşov.

During his career Cristian Falup-Pecurariu was President of the European Association of Young Neurologists and Trainees (EAYNT), EAYNT Liasion Officer with World Federation of Neurological Society, co-representative of Europe on the International Working Group for Young Neurologists and Trainees (World Federation of Neurol-ogy), Secretary of the EFNS/MDS-ES Panel on Movement Disorders and currently is member of the Educational Committee of MDS-ES and MDS Leadership Task Force.

His research focuses on non-motor aspects of Parkinson’s diseases and restless legs syndrome.

CRISTIAN FALUP-PECURARIU/Romania

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Cristian Dinu POPESCU is a professor of Neurology at the University of Medicine and Pharmacy “Gr. T. Popa”Iasi. He graduated from the same University in 1975 and holds a PhD from 1991.

He is the head of the Neurology Clinic in The Clinical Rehabilitation Hospital in Iasi, Romania, where he conducts his clinical and scientific activity.

Since 2008 he is chief of the Neurology Department and also the chief of the VI th Medical Chair of the IasiMedical University.

He is a member of national and international professional associations (vice president of the Romanian Society of Neurology, member of the Society for Study of Neuroprotection and Neuroplasticity, Society of Parkinson’s Disease and Movement Disorders, European Council of Neurological Rehabilitation, Balcanian Medical Union). He was an invited speaker in most of the important national neurology scientific events during the last years. He is a local coordinator for MS immunomodulatory treatment. He initiated and coordinated the organization of the National Multiple Sclerosis Conferences during the last 5 years.

He has authored or coordinated 5 books and took part in writing of 12 other books as coautohor, and more than150 papers.

His main fields of interest have been aging of the brain and its vascular system, multiple sclerosis, rehabilitationin stroke and other neurological diseases. Neurorehabilitation and neuroplasticity are among the main topics ofconcern, both in current clinical practice and regarding the research activities.

His group was among the first to use functional electrical stimulation in Romania - current research targetsapplications and effects of FES in stroke, MS and Parkinson’s disease.

He is the coordinator of one of the first groups in our contry to use transcranian magnetic stimulation in neurology – both in clinical practice (diagnostic and therapeuthical TMS) and for research (cortical neuroplasticity and neuromodulation)

CRISTIAN DINU POPESCU/Romania

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since 2010 Senior Professor at the University of Würzburg, Medical School, Germany1986 - 2010 University-Professor (University Würzburg); Head, Clinical Neurochemistry, Department of Psychiatry, Psychosomatics and Psychotherapy at the University of Würzburg, Medical School, Germany1983 titl. a. o. University-Professor (TU Vienna)1979 Associate Professor (University-Dozent) TU Vienna1971 - 1986 Head, Clinical Neurochemistry, Ludwig Boltzmann Institute (LBI) for Neurochemistry (1971 - 1975) and LBI Clinical Neurobiology (1976 - 1986), Lainz-Hospital, Vienna, Austria1970 Doctor techn. Degree1969 - 1971 Assistant Professor

Honors and awarded memberships (selection)

2013 Honorary Member, Austrian Society for Parkinson’s Disease2012 Edit. Board Member, International Association of Neurorestoretology (IANR)2011 WFN - Association of Parkinson Disease Related Disorder- Lifetime Award2008 Honorary Dr. degree International University Catalunya, Barcelona, Spain2007 Honorary Member of the Hungarian Academy of Sciences; Member of the Deutsche Akademie der Naturforscher Leopoldina; Honorary President of the German Society for Parkinson’s Disease2006 Honorary membership of the German Society of Biological Psychiatry2005 Honorary membership of the Austrian Alzheimer Society2004 Most cited chemist in the field of medicine1991 AGNP - Award, Award for psychopharmagological research1986 Senator Dr. Franz Burda-Award

Project coordination, membership in collaborative research projects (selection)

current International joint project in the field of clinical and experimental studies on Parkinson’s disease and dementia of Alzheimer type with: M.B.H. Youdim (Haifa), T. Nagatsu (Aichi), M. Naoi (Gifu), W. Maruyama (Aichi), Z. Lackovic, M. Salkovic (Zagreb) and E. Grünblatt (Zürich)2004 - 2011 DAAD-Stability Pact Project : Establishing the role of diabetes type II as risk factor for Alzheimer’s disease (with S. Hoyer, M. Salkovic, E. Sofic, E. Grünblatt)2002 - 2012 Brain Net Europe II: Standardization of human post-mortem brain studies at an European level (Europen FP 7 project)2002 - 2008 BMBF Kompetenznetz HIV/AIDS2002 - 2008 DFG-project “Benzodiazepines”2000 - 2012 VITA - Project (Vienna Transdanube Aging Study): A prospective longitudinal aging study to elaborate risk factors for AD1999 - 2012 Head of the Brain Bank Center (BBC) Würzburg of the National Brain-Net, Germany1991-1998 BMBF Schwerpunkt “Parkinson”

More than 1.100 publications in the field of Neuroscience

PETER RIEDERER/Germany

102

Current titles and positions:a. Academic activity:since 2003 - Associate Professor, Department of Neurology, State University of Medicine and Pharmacy “Nicolae Testemiţanu” Chisinau, Republic of Moldovab. Clinical activity:since 1994 - Consultant Neurologist at the Institute of Neurology and Neurosurgery in Moldova

Previous academic and professional work:1997-2003 – Assistant professor Department of Neurology, State University of Medicine and Pharmacy “Nicolae Testemiţanu” Chisinau, Republic of Moldova

Undergraduate and graduate studies:1986 - 1992 State University of Medicine Chisinau, Moldova

Postgraduate Studies:2014 - Salzburg Cornell Seminars “Palliative Care in Neurology”, Austria2012 - 1st International Course of Neuroepidemiology in Eastern Europe, Chisinau, Republic of Moldova.2010 - Regional educational course of EFNS Chisinau, Moldova.2010 - Internship in Neurology, Medical University of Craiova, Romania.2005 - Education Course of World Federation of Neurosurgical Societies, Chisinau, Republic of Moldova.2003 - Salzburg Cornell Seminars in Neurology, Austria2003 - Clinical internship program of EFNS “Department to Department “, Hamersmith Hospital, London, UK.2001 - Clinical Internship Medical University, Iasi, Romania.2000 - Internship at the Department of Manual Therapy, Stavropol, Russia.1994-1997 - PhD studies in the Department of Neurology and Neurosurgery, State University of Medicine and Pharmacy “Nicolae Testemiţanu” Chisinau, Republic of Moldova 1992-1994 - Residency in Neurology, Department of Neurology and Neurosurgery, State University of Medicine and Pharmacy “Nicolae Testemiţanu” Chisinau, Republic of Moldova

Grants:2003-2004 –Grant CRDF - MRDA MB-3037 ”Demyelination of nerve fibers and axonal degeneration in the central and peripheral nervous system in neuropathy (similarities and differences) “. Investigator.

Projects:Multicenter, Double-blind, Randomized, Parallel-group, Monotherapy, Active-control Study to Determine the Efficacy and Safety of Daclizumab High Yield Process (DAC HYP) versus Avonex® (Interferon α 1a) in Patients with Relapsing-Remitting Multiple Sclerosis. Sub-investigator (study coordinator)

Memberships Moldovan Neurological SocietyEuropean Neurological SocietyMoldovan Society for the Study of PainEuropean Pain Federation

MARINA SANGHELI/Republic of Moldova

103

STUDIES: B.S. (chemistry) Illinois Institute of Technology (1969); Ph.D. (biochemistry) University of South Dakota (1973); Laurea in chemistry, University of Padua (1990)

CAREER: NIH Postdoctoral Fellow, Department of Medicine, University of California, San Diego (1973-1976); Fellow in Human Genetics, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio (1977); Postgraduate Research Biologist, Department of Biology, University of California, San Diego (1978); Assistant Research Biologist, Department of Biology, University of California, San Diego (1979-1982); Associate Research Biologist, Department of Biology, University of California, San Diego (1983-1987); Head, Laboratory of Neuropharmacology, Neuroscience Research Laboratories, Fidia S.p.A. - Abano Terme, Italy (1987-1993); Principal Scientist and Head, Laboratory of Cell Biology, Researchlife S.c.p.A. (a Lifegroup Company), Biomedical Research Center, St. Thomas Hospital, Castelfranco Veneto (TV), Italy (1993-1996); Visiting Professor, Department of Pharmacology, University of Padova, Padova, Italy (1997); Assistant Director, Molecular Neurobiology Research, SmithKline Beecham Pharmaceuticals, New Frontiers Science Park, Harlow, United Kingdom (1998-2001); Senior Team Leader, Migraine and Stroke Research, Neurology & GI Centre of Excellence for Drug Discovery, GlaxoSmithKline R & D Limited, Harlow, United Kingdom (2002-2003); Senior Team Leader, Neuro Cell Sciences/Neurodegeneration Research, Neurology & GI Centre of Excellence for Drug Discovery, GlaxoSmithKline R & D Limited, Harlow, United Kingdom (2004-2007); Senior Team Leader, Target Validation Dept (Cognition and Pain), Centre of Excellence for Drug Discovery, GlaxoSmithKline R&D Limited, Harlow, United Kingdom (2008); Adjunct Professor, Department of Pharmacology and Anesthesiology, University of Padua, Faculty of Medicine, Padua, Italy (2009-present).

PROFESSIONAL MEMBERSHIPS: Sigma αI (The Scientific Research Society); Phi Lambda Upsilon (honorary chemistry society); Alpha Chi Sigma (professional society in chemistry/chemical engineering); Society for Neuroscience; International Society for Cerebral Blood Flow and Metabolism

JOURNALS EDITED: Editor-in-Chief, CNS & Neurological Disorders – Drug Targets; Associate Editor, American Journal of Neuroprotection and Neuroregeneration; Editorial Board Member, Nature Scientific Reports (Neuroscience); Councilor, International Association of NeurorestoratologyREVIEW PANELS: The Wellcome Trust (UK), Biotechnology and Biological Sciences Research Council (BBSRC) (UK), Austrian Science Fund (ad hoc review panel to evaluate interdisciplinary doctoral programmes in neuroscience)

RESEARCH INTERESTS: Molecular biology and cellular mechanisms of cell death in CNS aging, neurodegenerative disorders and neuroinflammation, astrocyte-microglia interactions, oligodendrocyte biology and diseases of demyelination. Track record of drug discovery project leadership in kinases, ion channels, G-protein-coupled receptors, DNA repair enzymes, growth factors, identification and optimization of tools for target validation studies, utilising RNAi, conditional and viral knockdown\outs\ins, transcriptomics, proteomics and in vitro cell-based disease or mechanism relevant assays in rodent systems.PUBLICATIONS: OVER 290 publications in the neurosciences, including book chapters and symposia proceedings.PATENTS: Pharmaceutical compositions containing monosialoganglioside GM1 or derivative thereof suitable for the treatment of Parkinson’s disease (Patent No.: US 6,620,792 B1), use of CRF receptor agonists for the treatment or prophylaxis of diseases, for example neurodegenerative diseases (US 2003/0186867 A1), treatment of conditions with a need of GSK-3 inhibition (PCT WO 02/062387 A1), use of CRF receptor agonists for the treatment or prophylaxis of diseases, for example neurodegenerative diseases (PCT WO 01/72326 A1), use of monosialoganglioside GM1 or N-dichloro-acetyl-lyso-GM1 for preventing or reversing neuronal degeneration induced by long term treatment with L-DOPA in the therapy of Parkinson’s disease (EP 0 770 389 A1)

REVIEWER FOR JOURNALS: Journal of Neuroscience, PNAS, Nature Reviews, The FASEB Journal, Journal of Neuroinflammation, Neurobiology of Disease, Neurobiology of Aging, Glia, Neuroscience, Apoptosis, PLoS One Biology, Journal of Pharmacology and Experimental Therapeutics, British Journal of Pharmacology, Neuropharmacology, European Journal of Pharmacology, Journal of Neurological Sciences

STEPHEN SKAPER/Italy

104

Johannes Thome studied medicine, philosophy and social psychology and obtained his MD/PhD degrees from Saarland University. After his training as a resident in Psychiatry and Neurology at the University of Wurzburg, he moved to the USA where he became a Postdoctoral Associate at Yale University. After two years of intensive and highly successful research in the area of molecular neuroscience and psychopharmacology, he returned to his native Germany and worked as Consultant Psychiatrist and Senior Scientist at the Central Institute of Mental Health Mannheim, University of Heidelberg. In 2004, Johannes moved to Wales and settled in Swansea, where he was the Professor of Psychiatry at the University of Wales Swansea. In 2010, he accepted the Chair of Psychiatry at the University of Rostock.

JOHANNES THOME/Germany

105

•Actualposition

Associate Professor, Department of Diabetes, Nutrition and Metabolic Diseases “Iuliu Hatieganu“ Medicine and Pharmacy University, Cluj-Napoca; Head of Diabetes, Nutrition and Metabolic Diseases Department, County Emergency Hospital Cluj-Napoca .

•Workexperience

1.10.2004 - present Associate Professor, MD, PhD

1.10.2010-present Teaching the Diabetes, Nutrition and Metabolic Disorders Module (4th year School of General Medicine)Teaching the Therapeutic Nutrition Class (3rd year School of Nutrition and Dietetics)Coordinator of student`s scientific activities and graduation thesesCoordinator and evaluator of student`s practical activitiesEditor of students’ readers.“Iuliu Hatieganu“ Medicine and Pharmacy University, Cluj-Napoca. 8 Victor Babes St, 400012 Cluj-Napoca.Website: www.umfcluj.roTeaching, research and medical assistance activities regarding Diabetes, Nutrition and Metabolic Disorders field.

1.10.1995 - 30.09.2004Lecturer, MD, PhDTeaching the Diabetes, Nutrition and Metabolic Disorders Module (4th year School of General Medicine)Coordinator of the Residency program in Diabetes, Nutrition and Metabolic DisordersCoordinator of student`s scientific activities and graduation thesesCoordinator and evaluator of student`s practical activitiesEditor of students’ readers.“Iuliu Hatieganu“ Medicine and Pharmacy University 8 Victor Babes St, 400012 Cluj-Napoca.Website: www.umfcluj.roTeaching, research and medical assistance activities regarding Diabetes, Nutrition and Metabolic Disorders field.

1981-1995Assistant professor, Medical Semiology Department Supervising practical activities for the 3rd year School of General Medicine students.Editor of students’ readersCoordinator of graduation thesesDevelopment of scientific research in diabetes risk, dyslipidemia.

“Iuliu Hatieganu“ Medicine and Pharmacy University 8 Victor Babes St, 400012 Cluj-Napoca.Teaching, research and medical assistance activities in Internal Medicine specialty.

IOAN VERESIU/Romania

106

1980-1981MD General MedicinePrimary Care Assistance for adults and children.Asuaju de Sus Primary Care Facility, Maramures County

1977-1980Intern MD Health care providing activities, scientific research Oncological Institute, Cluj-Napoca.

•EducationandTraining

1997PhD in Medical SciencesDiabetes, Nutrition and Metabolic Diseases

“Carol Davila” Medicine and Pharmacy University, Bucharest National Council of Attestation of Titles, Diplomas and Academic Certifications, 30-Oct 31st 1997, Confirma-tion no. 5347/20.11.1997

1996Attending Specialist MD Diabetes, Nutrition and Metabolic Diseases

National Council of Attestation of Titles, Diplomas and Academic Certifications, confirmation no. 862/17.04.1996

1986Specialist MDCardiologyNational Council of Attestation of Titles, Diplomas and Academic Certifications, confirmation no. 56/12.02.1986

1984Attending Specialist MDInternal MedicineNational Council of Attestation of Titles, Diplomas and Academic Certifications, confirmation no. 459/12.12.1984

•OrganizationMembership

European Association for the Study of Diabetes (EASD) Diabetic Foot Study Group (part of EASD) American Diabetes Association (ADA) Foot Care Study Group (part of ADA) Romanian Society of Diabetes, Nutrition and Metabolic Disorders Romanian Federation of Diabetes, Nutrition and Metabolic Disorders, Chair since 2010 International Task Force for Diabetic Foot of IDF (national representative) International Task Force for Diabetes Experts Panel from Accessing Countries (DEPAC), since 2009 Romanian Society of Diabetic Neuropathy, Chair since 2013 Honorary Member of the Hungarian Diabetes Society, 2014

107

Born, 1952, he specialized in Veterinary Medicine between 1971 and 1974 at the University in Munich, then changed to the University in Cologne in 1974 and specialized in Human Medicine from 1974 to 1980. In 1976 to 1979, he additionally studied biometric methods for pharmacology and clinical research at the Institute for Data Analysis and Study Planning in Munich.

While studying human medicine, he completed research work on pattern recognition in the visual brain and developed a pharmacodynamic Neuron Simulation Model at the Institute for Medical Documentation and Sta-tistics of the University at Cologne.

From 1985 to 1995, he was member of the Ultrahigh Dexamethasone Head Injury Study Group and leading biometrician of the German GUDHIS Study.

Since 1982 he holds advanced training courses on biometry for professionals in clinical research and university establishments. His work also involves human engineering of biometric software and GCP-compliant tutorials for biometric appraisal of clinical studies.

Since 1995 he cooperates closely with the Institute for Data Analysis and Study Planning as Senior Consultant for Biometry & Clinical Research. He planned and evaluated about 150 randomized clinical studies worldwide and is member of various international advisory boards including participation as biometric expert in regulatory authority panels and in FDA, EMEA, and BfArM hearings.

JOHANNES VESTER/Germany

108

Nationality: Romanian; GermanEducation:2012-present Professor of Experimental Neurology at the Department of Psychiatry and Head of the Research Molecular Psychiatry, University of Medicine Rostock2008-present: Professor of Pathobiochemistry, University of Medicine and Pharmacy, Craiova, Romania.2004-2012 Professor of Experimental Neurology at the Department of Neurology and Head of the Research Department Ernst-Moritz-Arndt University2004 Habilitation in Internal Medicine and Experimental Neurology, Medical Faculties of Erlangen-Nueren-berg and Greifswald. 2004 Associate Professor, Clinic of Neurology Ernst-Moritz-Arndt University, Greifswald. 1996-1998 Labora-tory Head, Clinic of Neurology, Ernst-Moritz-Arndt University, Greifswald1991 Post-graduate: Post-doctoral training at Ethel Percy Andrus Gerontology Center, University of South-ern California 1990 Graduate: PhD in Biochemistry Institute of Biochemistry, University of Karlsruhe, Germany

Present academic positionProfessor of Experimental Neurology at the Department of Psychiatry and Head of the Research Molecular Psychiatry, University of Medicine Rostock.

Main Domain of Research• Aging,Stroke,MolecularRehabilitation,Mooddisorders,preclinicalandclinicalresearch,therapeuticstrategies: drugs, stem cells• Expertise:agedanimalsmodelsofcerebralischemia;behavioralanalysis;recordingofEEGandvariousphysiological parameters by telemetric measurements; MRI for small animals; immunohistochemical proce-dures, proteomics, genomics.

HonoursRene Schubert Prize for Research on Ageing

Recent GRANTS: 7Amount: 6,7 millions Euros2007-2008BMWT: Automatisiertes Immunhistologisches Analysegerät (Development of an automatic immunostaining de-vice for floating tissue sections). Grant agreement no: 03ESFMV022Grant money: 70.000 Euro

2008-2011BMBF: Neuroprotective effecst of hypothermia. An MRI study.Grant agreement no: 0314107Grant money: 3,05 millions Euro

2009-2012FP7: Improvement of the research competitiveness in neuroscience at the Ernst Moritz Arndt University of GreifswaldAcronym: ImpactGGrant agreement no.: 229750Grant money: 1,05 millions Euro

AUREL POPA-WAGNER/Germany

109

2009-2012BMBF: Multimodal Approaches for Regenerative Stroke Therapies. Therapeutic benefit of bone marrow stem cells administered to aged rats after stroke. Acronym: MARSGrant agreement no: 01GN0982Grant money: 760.000 Euro

2010-2013FP7: Improvement of the research competitiveness in molecular imaging at the Ernst Moritz Arndt University of GreifswaldAcronym: EnVisionGrant agreement no.: 264143Grant money: 2,15 millions Euro

2011-2012BMBF: Systemic regulatory mechanisms to cope with persistent energy excess in aging systems.Grant agreement no: MOE 10/73Grant money: 24.000 EURO

2011-2014UEFISCDI: Age-related deterioration of biological pathways and their significance for brain tissue regeneration and functional recuperation after strokeAcronym: RegeneratomeGrant agreement no: PN-II-ID-PCE-2011-3-0848Grant money: 410.000 Euro

2012-2015UEFISCDI: Cellular therapy of stroke Acronym: CELESTGrant agreement no: PN-II-ID-PCCA 80/2012Grant money: 410.000 Euro

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SPONSORS

Romania

www.ssnn.ro‘‘RoNeuro’’

Institute for Neurological Research and Diagnostic,Cluj-Napoca, Romania

Tel.: 0374 46.22.22

str. Mircea Eliade nr. 37, 400364 Cluj-Napoca, RomâniaFax: 0374.461.674; Email: [email protected]

www.roneuro.ro

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